HIV Preexposure Prophylaxis Billing Guidelines

This guide outlines the billing procedures for HIV Preexposure Prophylaxis (PrEP) related tests, services, and medications. It emphasizes the importance of using the correct CPT/HCPCS codes when submitting billing, specifically advising against the use of the generalized administrative code 96372. The document details the associated CPT/HCPCS codes that should be used in conjunction with the appropriate preventative ICD-10 codes for various tests and services related to PrEP. It also references the USPSTF recommendation for individuals at high risk of HIV infection and mentions the CDC's discussion on implementation considerations for PrEP, including testing and monitoring protocols. The guide provides a comprehensive list of covered preventive diagnoses and their corresponding codes, ensuring that healthcare providers have the necessary information to comply with billing requirements for PrEP-related services.