The Illinois Department of Healthcare and Family Services (HFS) recently issued a provider release about billing for preventive services. The intent of the notice was to remind providers to follow the American Medical Association guidelines for the preventive evaluation and management CPT codes.
For children ages 0-20, HFS recommends that health screenings be provided on a periodicity schedule based on acceptable medical practice standards, such as those recommended by the American Academy of Pediatrics or the American Academy of Family Physicians, or the well-child visit and periodicity schedule located in the HFS Healthy Kids Handbook.
For adults ages 21 and older, providers must bill the age-appropriate preventive evaluation and management CPT codes. Payment will be limited to one preventive office visit per patient, per provider per year.
Illinois Health Connect wants to reminder providers that interperiodic health screenings -- such as administrative exams for adoption or insurance certification, as well as physicals for school, sports, camp or employment -- will continue to be covered when the correct diagnosis code is used. Providers should use the V70.3 diagnosis code with an interperiodic screening.
