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43.1.7.2 Follow-up Medical Check Up Visit
A follow-up check up visit, procedure code S-99211, is reimbursed at a maximum fee of $14.96 except for services performed in an RHC or FQHC setting. Follow-up check ups may be needed when required to complete necessary procedures related to the THSteps check up (e.g., to read a TB skin test, transportation and outreach work required by the provider to read a TB skin test, administering immunizations in cases where the child's immunizations were not up-to-date or medically contraindicated on the initial visit, and repeating laboratory work). A return visit to follow up on treatment initiated during the screen or to make a referral must not be filed as a follow-up visit.
Follow-up visits may not be billed on the same day as a THSteps visit.
A medical check up follow-up visit must be billed with a THSteps provider identifier to be considered for reimbursement for a THSteps visit. FQHCs must submit the same procedure code, but with modifier EP.
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