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Appendix B – Procedure Codes

Procedure codes identify what type of service is being provided. Procedure codes use CPT code language (and HCPC when appropriate). The specific code that’s added to the claim is based on the procedure code selected and the face-to-face time entered in the service note. Any add-on codes (e.g. “extra 15 minutes”) are automatically added based on the total face-to-face time. Modifiers, such as HK for ICC, are also added automatically based on other input in the system.

Procedure codes are primary-driven, meaning that counties should not be adding or removing procedure codes, nor adjusting the progress note type or licensure type associated with the code. Counties do have to configure the rates of the procedure codes.

 

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