Guidelines for Billing Preventive Services
Defines which preventive services, related CPT/HCPCS/vaccine codes, site-specific requirements, and billing instructions for Culinary Health Fund members; applicable to providers billing the Fund.
No material clinical or coverage changes in this revision.
Covered Preventive Services
Preventive services covered at 100%
Listed preventive services are covered at 100% with specific billing codes and site requirements where noted.
Preventive office visits
- Bill using CPT codes 99381-99387 (new patient) or 99391-99397 (established patient); initial newborn care billed with 99461.
Contraceptive services and devices
- Bill professional services with codes 58300, A4261, A4266, S4981; IUD devices using J7300, J7301, J7302; implants J7307; injection J1050 and 96372; counseling may be billed with 99401 if not done at the preventive visit.
Routine immunizations and vaccine administration
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