These services are generally offered by primary care providers. No authorization is required for participating providers.

Refer to CPT guidelines for documentation standards. Codes will process as preventive benefits.

Fully funded and self-funded plan members 

CPT codes for Risk Factor and Behavioral Change Modification, 99401 - 99420, are payable. 

Medicare and Priority Health Choice (Healthy Michigan Plan and Medicaid) members

• Codes 99401 and 99402 are separately payable for Medicaid/Healthy Michigan Plan members. 
• Codes 99406 and 99407 are separately payable for both Medicare and Medicaid/Healthy Michigan Plan members.
• Code 99420 is separately payable once annually for Healthy Michigan Plan members only.
• Codes 99403, 99404, and 99411-99419 cannot be billed separately.