Medicare Part B always covers 3 routine immunizations:
- Pneumococcal pneumonia (PPV)
- Influenza (the flu)
- Hepatitis B (if you are at medium to high risk)
Preventive Care Services
CPT 99381-99387 – Initial Comprehensive Preventative Medicine evaluation and management.
CPT 99391-99397 – Periodic Comprehensive Preventative Medicine reevaluation and management.
CPT 99391-99397 – Periodic Comprehensive Preventative Medicine reevaluation and management.
Includes care for preexisting conditions or minor problems. Excludes behavior change intervention (99406-99409)
(better known to offices as complete Physical Exams, Well Checks, routine physical, annual physical, annual exam, well exam, routine exam, full physical, annual routine physical)
Risk factor and behavior change modification.
CPT 99401–99405 Preventive medicine counseling and/or risk factor reduction and behavioral change intervention services provided at an encounter separate from the preventive medicine examination in areas such as family problems, diet, and exercise.
CPT 99406–99407 Smoking and tobacco use cessation counseling.
CPT 99408–99409 Alcohol and/or substance abuse structured screening.
Medicare doesn’t cover preventative services.
The CMS recognizes two HCPCS codes for billing for behavioral counseling for obesity
G0447 – face-to-face behavioral counseling for obesity, 15 minutes
G0473 – face-to-face behavioral counseling for obesity, group (2–10), 30 minutes.
Transitional Care Management
To increase the quality of patient care and reduce hospital re-admissions.
CPT Code 99495 – TCM services with moderate medical decision complexity (face-to-face visit within 14 days of discharge)
CPT Code 99496 – TCM with high medical decision complexity (face-to-face visit within 7 days of discharge)
The 30-day TCM period begins on the date the beneficiary is discharged from the inpatient hospital setting and continues for the next 29 days.