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Official Description

Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle
Short Descr Injection of hiv prep drug
Coverage Carrier Priced
Pricing Indicator(s) 13 – Physician Fee Schedule - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
MPI A – Not applicable, as HCPCS priced under one methodology
BETOS P5E – Ambulatory procedures - other
TOS Code(s) 1 – Medical care
Added Date 1/2/2024
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 5 - Incident To Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2024-01-02 Added Code added.
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Description
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Description
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