A family planning annul exam consists of a comprehensive health history and physical examination, including medical laboratory evaluations as indicated, an assessment of the client's problems and needs, and the implementation of an appropriate contraceptive management plan. The annual exam is allowed once per fiscal year, per client, per provider. Other family planning office or outpatient visits may be billed within the same year.
Note: Title XIX providers and Title V and XX providers use different codes to file annual exams.
Title XIX Only
Procedure Code
Fee for Title XIX
1-99204 With modifier FP * or 1-99214 With modifier FP*
$70.64
$41.46
Title V and XX Only
Procedure Code
Fee for Title V or XX
1-99203 With modifier FP or 1-99214 With modifier FP
$48.27
$41.46
Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved.
