According to the latest announcement MVP Health Plan will change the reimbursement of sick E/M codes when they are billed on the same day as a preventative codes.
This policy applies to Primary Care Physicians.
According to the new reimbursement policy the sick E&M codes will be reimbursed at 50% of allowable amount if the codes are billed on the same date of service as the preventative codes.
The reimbursement will be applied with or without the modifier 25 present.
Policy applies to the following codes:
Preventive medicine services are represented in evaluation and management (E/M) codes 99381–99429. These E/M codes may be reported by any qualified physician or other qualified healthcare professional.
Preventative cpt codes 99381–99397 for comprehensive preventive evaluations are age-specific, beginning with infancy and ranging through patients age 65 and over for both new and established office patients.
E&M codes may include: 99202-99205, 99212-99215
For more information please refer to MVP Evaluation and Management (E&M) policy.
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