Clinical support

Priority Health Medicare pays for yearly comprehensive physical exams even though Medicare does not, so please continue to encourage your patients to schedule a physical exam. Be sure to include verification of current and past health conditions in their medical records.

Tips:
Please use one of the following codes when you complete your patient’s physical exam:

• Preventive medicine new patient: 99385, 99386 and 99387
• Preventive medicine established patient: 99395, 99396 and 99397

The Centers for Medicare & Medicaid Services are using a risk adjustment model for Medicare reimbursement, based on documentation and ICD-9 codes reported. If a health condition has resolved, please indicate that it’s no longer active. If a health condition is not listed, please supply us with the information. 

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