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  • 1.  PrEP

    Posted 01-13-2022 22:39
    How has anyone navigated the new regulations that say insurers cover cost of appointments and labs for PrEP?
    What ICD-10 code are you billing (I use high risk sexual behavior or HIV Exposure)? What E/M Code are you billing (99213/99214)?  Does this also count if we also address other issues as a secondary like Anxiety, etc on the same note?
    Basically my questions are... who is supposed to be responsible? Patient? Provider?  Does the patient have to contact their insurance after/before eacsh appointment to make sure they aren't charged?  Our office automatically charges copay when they check in, should we not now if it's only PrEP?

    What has been everyone's experience? Any tips?

    I attached the FAQ for the new recommendation.
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    Randy Gelow, MD AAHIVS
    Banner Health Center Greenway
    Phoenix AZ