Procedure code 1-99204 or 1-99214 with modifier FP and WHP diagnosis 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 year, per client, per provider. Subsequent visits within the same year must be billed as an office visit or other outpatient visit.
Procedure Code
Fee for Physicians
Fee for Family Planning Clinics
1-99204 with FP modifier
Clients 20 years of age and younger: $90.07 Clients 21 years of age and older: $81.24
$70.64
1-99214 with FP modifier
Clients 20 years of age and younger: $52.86 Clients 21 years of age and older: $47.68
$41.46
Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved.
