Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

CPT Category II codes are supplemental tracking codes used to support quality patient care and performance management. CPT II codes are:

• Billed in the procedure code field in the same way as CPT Category I codes.
• Used to describe clinical components usually included in evaluation, management or clinical services.
• Billed with a $0 billable charge amount since they are not usually associated with any relative value.

 

Under this new incentive program, Empirew ill reimburse contracted Medicare Advantage providers for submitting select HEDIS®-related CPT Category II codes for eligible members.

Using these CPT Category II codes for Medicare Advantage members will:

• Help providers address clinical care opportunities.
• Facilitate timely and accurate claims payments.

 

Detailed information about this program, including a list of applicable codes, will be sent to providers.

ABSCARE-0006-19

 

75975MUPENMUB 02/19/2019