National Clinical Training Center for Family Planning



VCB TranscriptTitle: An Introduction to Billing and Coding for PrEP SerivcesSpeakers: Edwin Corbin-Gutierrez and Ann FinnDuration: 00:36:58NCTCFP (00:01):Welcome to this virtual coffee break sponsored by the National Clinical Training Center for Family Planning. The National Clinical Training Center for Family Planning is one of the training centers funded through the Office of Population Affairs to provide programming to enhance the knowledge of family planning staff. Our guest speakers today are Edwin Corbin-Gutierrez and Ann Finn, and in this presentation entitled An Introduction to Billing and Coding for PrEP Services, they will be providing an introduction to billing and coding for pre-exposure prophylaxis for HIV prevention, or PrEP.NCTCFP (00:34):Edwin Corbin-Gutierrez is an associate director on the Health Systems Integration team at NASTAD, a nonprofit focused on addressing intersecting epidemics of HIV and viral hepatitis. Ann Finn, who you may know from our Coding with Ann podcast series, is a healthcare reimbursement consultant and national trainer on billing, coding, and revenue cycle improvement, whose work focuses primarily on sexual and reproductive health services. Before we get started, we have several disclosures.NCTCFP (01:08):Successful Completion: Contact hours will be prorated according to documented attendance. To receive contact hours, participants must complete and submit the online evaluation request for credit form. CNE and Certificates of Completion will be emailed approximately four weeks after the completion of the evaluation request for credit form.NCTCFP (01:32):Commercial Support and Sponsorship: There is no commercial support for this training.NCTCFP (01:37):Non Endorsement of Products: The University of Missouri-Kansas City School of Nursing and Health Studies and the ANCC do not approve or endorse any commercial products associated with this activity.NCTCFP (01:53):Conflict of Interest: In accordance with continuing education guidelines, the speakers and planning committee members have disclosed commercial interests or financial relationships with companies whose products or services may be discussed during this program. Edwin Corbin-Gutierrez and Ann Finn have no conflicts of interest to report.NCTCFP (02:14):The Planning Committee: Katherine Atcheson, Angela Bolen and Sharon Colbert have nothing to disclose. Katherine Witt serves on the advisory panel for Afaxys, which has been resolved.NCTCFP (02:26):Acknowledgement of Funding: This presentation was supported by grant number 5FPTPA0060290200 from the United States Department of Health and Human Services, HHS; Office of the Assistant Secretary of Health, OASH; Office of Population Affairs, OPA. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS, OASH, or OPA.NCTCFP (03:05):Accreditation Statement. Continuing Nursing Education. The University of Missouri-Kansas City School of Nursing and Health Studies is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. This webinar offers .5 contact hours for nurses.NCTCFP (03:27):After attending this session, participants should be able to discuss common billing codes used in providing pre-exposure prophylaxis, or PrEP, and discuss billing coding strategies to minimize patient cost sharing and avoid cost-related PrEP discontinuation.NCTCFP (03:48):We'll be covering five topics. First, we're going to provide some context regarding the current PrEP financing landscape and discuss the importance of coding strategies for PrEP access. Then we'll introduce the billing and coding guide for HIV prevention services that NASTAD developed. We will also go into key considerations when coding PrEP-specific services, both to maximize revenue, but also decrease out-of-pocket costs for the patient. We'll walk through three sample scenarios to provide concrete examples of these billing strategies, and we'll conclude with a few resources that we would like to share with you. And now, onto Edwin.Edwin Corbin-Gutierrez (04:34):Hi, everyone. PrEP is a daily pill that people can take to prevent HIV acquisition. The Centers for Disease Control and Prevention indicate that when taken every day, PrEP reduces the risk of getting HIV from sex by about 99%. Despite years of proven efficacy, individuals who are at risk for HIV continued to face unnecessary barriers to PrEP access, including a lack of awareness on the part of primary healthcare providers, gaps in healthcare coverage, and prohibitive expenses associated with the intervention.Edwin Corbin-Gutierrez (05:08):Although PrEP uptake is accelerating across the country, inequities in access are still alarming. For example, according to AIDSVu, women represent only 6% of PrEP users across the country. The AIDS Institute at the New York State Department of Health has identified a number of PrEP key challenges and opportunities on which we need to take action to increase PrEP among women. Many of these recommendations from New York might be relevant across the country.Edwin Corbin-Gutierrez (05:40):For example, one of the recommendations is to improve awareness about PrEP among providers. They recommend doing this through academic detailing and messaging that highlights the voices of women using PrEP, given that almost all social marketing focuses on gay men. They also encourage providers to take a comprehensive view of the structural, social, behavioral and biological factors that make women vulnerable to HIV. These recommendations also prioritize framing PrEP as part of routine health care for women and approach aimed at reducing stigma, and the recommendations emphasize the importance of ensuring that there are adequate resources to help pay for PrEP related services and making PrEP available in as many settings as possible.Edwin Corbin-Gutierrez (06:28):In this context, family planning clinics have a critical role to play in PrEP scale-up. Family planning clinics are particularly well equipped to provide affirming, inclusive sexual health services. Being able to access culturally responsive services is critical, given that patients often report facing judgment from their provider and unwillingness to disclose sexual behaviors and practices. Family planning clinics also have demonstrated excellence in managing vulnerable patient populations, helping patients navigate through complex healthcare coverage barriers to ensure that cost is not a barrier to care.Edwin Corbin-Gutierrez (07:05):As a quick reminder, the US Public Health Service PrEP guidelines, which were updated in 2017, recommend daily use of the medication, seeing a clinician every three months, and a core set of labs. The guidelines also recommend additional tests by patient population and risk factors. For example, it recommends that women and trans men of childbearing potential take a pregnancy test during the initial visit and subsequently every three months, or annually based on contraception use. The guidelines also recommend a series of additional services for some patients, including additional support services to maintain adherence.Edwin Corbin-Gutierrez (07:48):Paying for PrEP care directly would be prohibitive expensive for almost all patients. The wholesale acquisition costs or 30 days of the medication for PrEP in the first quarter of 2019 was $1,758. The annual cash price of the necessary lab tests for PrEP candidates varies based on risk, ranging between $502 for heterosexual males to $1,722 for gay and bisexual men and other men who have sex with men, due to more frequent STD testing.Edwin Corbin-Gutierrez (08:24):Given these costs, patients depend on being able to secure sufficient coverage and financial assistance to access the intervention. Assistance programs from the drug manufacturer, private foundations, and state public health departments are available to cover the costs associated with the medication, either through copay assistance for individuals who are insured, or medication assistance for those who are uninsured. But only a handful of state programs also provide assistance for PrEP-related clinical visits and lab tests.Edwin Corbin-Gutierrez (08:58):Studies of the accessibility of PrEP, given its cost, especially among low income patient populations and populations facing other challenges in access to healthcare services, indicate that it is critical that providers and the clinical team as a whole do everything they can to reduce the cost of PrEP to the patient.Edwin Corbin-Gutierrez (09:20):For example, in a survey of PrEP accessibility among people who use drugs, participants indicated that cost was the most critical attribute in a PrEP program. Among people who inject drugs in Washington DC, 47% reported that they would very likely use PrEP if it were available without cost. Studies also documented similar concerns about the cost of the intervention among women and other key groups at high risk of HIV across the country. 44% of women surveyed in a family planning clinic in Philadelphia indicated that the cost of PrEP was a concern when considering whether to use PrEP. In-depth interviews with young trans women in Philadelphia also revealed that concerns about PrEP costs were an obstacle to PrEP uptake. Given this context, billing, coding staff and the entire clinical staff have a critical role to play in helping patients decrease out-of-pocket costs they may face when trying to access the intervention.Edwin Corbin-Gutierrez (10:26):To develop the billing coding guide that we will be presenting in this webinar, NASTAD convened an advisory group made up of a coding expert, the HIV Medicine Association, health department staff and clinical providers, to inform its creation through the guidance that seeks to assist providers in maximizing the benefit that their patients receive from their health insurance coverage for PrEP related services, and disseminate billing strategies that can reduce the out-of-pocket costs to the patient, which is also important. Maximizing billing for PrEP services is also important for providers' sustainability, and it eases their ability to scale up access for the intervention.Edwin Corbin-Gutierrez (11:08):Through the development process, several key issues were identified. Payment by insurance companies for these services can be problematic, depending upon whether the payer, for example, Medicare, Medicaid, or private insurance plans recognize the service; the credentials of the person providing the service and the setting in which it is provided. In particular, family planning clinics and other HIV prevention programs offer a range of vital PrEP-related services that are difficult to translate into billable services and units. These include linkage to care, adherence counseling, and intensive risk reduction counseling.Edwin Corbin-Gutierrez (11:48):Although some of the services are performed by physicians, advanced practice registered nurses or other providers sometimes have a harder time billing for services provided by staff working under the supervision of these medical professionals. On the other hand, other providers are not maximizing the special flexibilities that allow community health workers or other non-licensed health professionals and peers to deliver some of these services.Edwin Corbin-Gutierrez (12:15):The guide includes three sets of services related to PrEP that could be helpful for family planning clinics looking to maximize their billing strategy. The guide presents three options to build for the initial and followup PrEP-related clinical visits, with considerations regarding the type of services delivered, the providers delivering the service, the setting, and other considerations such as payment structure.Edwin Corbin-Gutierrez (12:41):The guide lists the codes for lab tests indicated for PrEP, and includes labs covered as preventative services. Providers that want to provide comprehensive support services will benefit greatly from the various strategies to provide and bill for these services, including PrEP adherence counseling by a physician, an advanced practice nurse, physician assistant, high-intensity behavioral counseling to prevent STIs, chronic care management services, care coordination, linkage and adherence services by community health workers, and other non-licensed peer providers in non-traditional healthcare settings, and targeted case management.Edwin Corbin-Gutierrez (13:25):The goal of this coding guide is to describe scenarios for PrEP initiation and follow up, adherence, linkage and other counseling services, and for lab tests for HIV and other STIs. It discusses CPT codes and ICD-10 diagnosis codes that could be reported as part of filing a claim with the patient's insurance company or government payer. It also includes a discussion of being able to provide the service, either directly or under the supervision of a licensed medical professional.Edwin Corbin-Gutierrez (13:54):Unfortunately, we should note that there are many services provided by HIV and other public health program staff members that are either not described by a CPT code or not performed by a healthcare professional who is credentialed by an insurance company. This limits the ability to seek reimbursement from the insurer for these services.Edwin Corbin-Gutierrez (14:17):The guide also includes a list of allowable ICD-10 diagnosis code recommendations gathered from our panel of HIV providers. The clinical provider supplement to the US Public Health Service guidelines on PrEP also includes a very comprehensive list of codes that many providers find helpful. With that, let me turn it over to Ann Finn to walk us through a few key services described in the guide, and three scenarios that show how to put the guide into practice and maximize your PrEP building strategy.Ann Finn (14:52):Great. Hello, everyone. Let's look a little closer at some of the codes recommended in this guide to capture and bill for the visit and counseling. Prior to receiving a prescription for PrEP, an individual would need counseling and lab testing. They may have a health history taken, and lab tests must be ordered by a physician, advanced practice nurse, or physician assistant. If the medical visit and counseling is done by one of these providers in the office outpatient facility setting, the visiting counseling might be billed using an outpatient evaluation and management code, or E/M, such as 99203 or 99213, based off of the three key components performed, including history, exam, and medical decision-making. Or if over half of the face-to-face time with the provider is spent on counseling and coordination of care, which is often the case with PrEP services, time can be used to determine the appropriate E/M code. The counseling may also be part of a preventive well visit and billed using the preventive codes such as 99385 or 99395, based on the patient's age and if they are new or established to the practice.Ann Finn (16:14):An alternative is to bill for counseling with preventive medicine counseling codes. CPT has a series of preventative medicine codes for risk factor reduction, including the 994 codes seen here. The codes in the 99401 to 99404 series are used for individual counseling, and codes 99411 and 99412 are used for group counseling. These time-based codes are used to document preventive counseling in patients without a diagnosis. Counseling for PrEP adherence in patients without HIV fits into this description.Ann Finn (16:55):There is also a code for group services, 99078, physician educational services rendered to patients in a group setting, which lists examples of prenatal obesity or diabetic instructions in the description that may be applicable to certain PrEP situations. I recommend checking with your Medicaid agency and other third party payers to determine if these are active billing codes.Ann Finn (17:27):Modifiers are two digit codes that are applied to CPT and HCPCS codes when submitting a claim to insurance company or payer. These two digit modifiers do not change the definition of the code but inform the payer of special circumstances related to the provision of a service. Here is a list of PrEP-related HIV and STD screening and counseling services that have a grade A or B from the US Preventive Services Task Force, or the USPSTF. These services should be billed with no cost sharing to the patient. Although the USPSTF also gave PrEP a grade A recommendation this year, health plans have 12 months from the date in which recommendation is made to implement the recommendation. Evelyn will discuss this more at the end of the webinar.Ann Finn (18:20):As you recall from Edwin's earlier slide on a timeline of PrEP services, prep guidelines include HIV, hepatitis, and STI testing and initiation in every three months, as well as follow up provider appointments every three months. We need to have a way to tell the payer the services billed are considered preventive for this visit, and there should be no cost sharing or cost for copay.Ann Finn (18:45):Modifier 33 was created in response to the patient protection and Affordable Care Act, and indicates a service provided is a service that carries an A or B rating with the USPSTF, and is required to be provided without patient cost sharing. By appending modifier 33 to the CPT or HCPCS code for each applicable diagnostic or therapeutic service with this rating, the medical provider alerts the insurer that a covered preventive service was provided and that patient cost sharing does not apply. For separately reported services specifically identified as preventative or inherently preventive for the code description, the modifier should not be appended. An example would be a preventive well visit code such as 99395. Since cost is often a barrier to accessing an adherence to PrEP, it's important to accurately include modifiers if required on the insurance claim. Contact your local Medicaid agency and other third party payers to clarify their requirements and any questions so you don't lose out on being reimbursed for your services.Ann Finn (19:56):Two other modifiers that are sometimes needed when screening for HIV include modifier 92, alternative laboratory platform testing. This modifier indicates the test does not require permanent space and it can be handheld and carried to the patient for immediate testing, such as an HIV rapid test. Modifier QW is defined as a Clinical Laboratory Improvement Amendment, or CLIA waived test, which include test systems cleared by the FDA designated as simple, at low risk for error, and are approved for waiver under the CLIA criteria. Examples of CLIA waived tests would include codes 86701 to 86703, or 87389 for the HIV rapid test. It's important to accurately include modifiers on the CPT or HCPCS codes as required on the insurance claim. Again, contact your third party payers about their policies and train staff on correct modifier billing, and follow up on any payment issues.Ann Finn (21:03):Every CPT code that is billed needs to be supported by an ICD-10 diagnosis code. Remember for every what there is a why. For the purposes of PrEP counseling, many groups use ICD-10 Z20.6, contact with and suspected exposure to HIV, or Z20.2, contact with and suspected exposure to infections with a predominantly sexual mode of transmission. Two other commonly used screening codes include Z11.4, encounter for screening for HIV, and Z11.3, encounter for screening for infections with a predominantly sexual mode of transmission or STIs.Ann Finn (21:50):Prior to starting PrEP, the billable healthcare professional order screening laboratory tests for HIV and other sexually transmitted infections. They may also order a metabolic panel and/or a pregnancy test. After starting PrEP medication, medical provider will order a surveillance lab test every three months. Although screening for HIV has an A rating from the USPSTF and is covered with outpatient due balance, insurers may not treat the test provided every three months in the same way. More frequently obtaining HIV tests may be considered diagnostic rather than screening once treatment is initiated. As a result, patients may have a copay and are deductible for these lab tests. Remember to include the modifier 33 for preventive services needed, and follow up with a payer to clarify any reimbursement questions.Ann Finn (22:46):Let's look at a scenario. Our first scenario is with Alicia. Alicia is a 25-year-old cis hetero Latino woman who comes to the clinic for her annual well-woman exam and to renew her prescription for oral birth control pills with her PCP. During her exam she states she has had five male partners in the last year, all with unknown HIV statuses, and that she hardly ever uses condoms. After 15 minutes of education and counseling, Alicia decides to try PrEP, as she doesn't feel comfortable discussing condom use with her partners. She is given a rapid HIV test which is negative. A urine sample is also taken for chlamydia and gonorrhea screening. As Alicia has no history of contraindicating conditions, she is given a 30 day prescription for PrEP and referred to a patient navigator for longterm PrEP care. What codes would we use to bill for this service?Ann Finn (23:48):Since Alicia returns to the clinic for her well-woman check and pill refill, we would use a preventive E/M code 99395, based on her being an established patient and her age. The ICD-10 code Z01.419 for GYN exam without abnormal findings and the Z30.41 cover the annual and the contraceptive management. She is also counseled for 15 minutes on HIV and risk reduction, so we can include the code Z71.7 to support the HIV counseling. Since the preventive medicine visit E/M codes include counseling as a component, we would not include another CPT code for the counseling.Ann Finn (24:33):Alicia is being screened for chlamydia and gonorrhea. ICD-10 ZE11.3, STD screening, supports the ordering of tests that are being sent to the lab. The lab typically bills the payer directly for the actual tests. She is also getting an in-house HIV rapid test which is negative. We would bill this point of care test with the appropriate CPT code, such as 86703 along with the Z11.4 HIV screening, or Z20.6, contact with and suspected exposure to HIV. Since Alicia has had unprotected sex with five partners, which is considered high risk, Z72.51 can also be coded. Alicia's visit and services are inherently prevented, so we will need to include the modifier 33. The pharmacy filling the prescription would typically bill the insurance for the PrEP medicine using the NDC or National Drug Code. There is no HCPCS applied code established at this point for the PrEP drug.Ann Finn (25:43):Let's look at scenario two now for Kevin's visit. Kevin is a 39-year-old cis bisexual black man who presents with a request for PrEP because he has recently started dating Mark, a cis man who is HIV positive. Kevin states that Mark is currently in treatment for HIV and they have used condoms most of the time, but that both of them would like to stop using condoms altogether. He is given a rapid HIV test which is negative, has blood blood drawn for a creatinine lab, gives a full health history, and is counseled for over 50% of his 20 minute face-to-face visit with the clinician on HIV and PrEP.Ann Finn (26:24):As Kevin doesn't have a history of contraindicating conditions, he is given a 30 day prescription for PrEP and agrees to come back to the clinic if his creatinine clearance is abnormal. He is referred to a patient navigator for longterm PrEP care. What codes would we need to bill for this visit?Ann Finn (26:44):Since Kevin is new to the clinic and is counseled for the majority of the visit and is not receiving a preventive well-check at this visit, we would bill a 99202 code based off of the 20 minutes of face-to-face time with the clinician. We could also base the code off the three key components of documented history exam and medical decision-making. We would include the ICD-10 codes Z20.6, contact with and suspected exposure to HIV, since he is having sex with a partner with HIV, and Z71.7, HIV counseling. We could also include Z72.52, high risk homosexual behavior, since Kevin is an MSM or a male having sex with a male who has HIV and they are inconsistent with condom use.Ann Finn (27:39):Kevin has blood drawn for the creatinine lab test, so we would bill for the venipuncture. We would also need to include a modifier 25 on the 99202 code to indicate it was separate and distinct from a blood draw to avoid a denial of payment. The outside lab will typically bill the third party payer for the tests. Since all the services are covered as a grade A/B recommendation for PrEP with no cost sharing expected, we would also want to include the 33 preventive service modifier on each service.Ann Finn (28:15):Our scenario number three is Shayna's visit. Shayna is a 31-year-old African American woman whose husband is HIV positive. She has been taking PrEP for the last 18 months and is presenting today for routine continuing PrEP care. Three months ago, Shayna had her IUD removed at the clinic, and she and her husband are now actively trying to conceive. Shayna has blood drawn for HIV test and creatine clearance, and is given a urine pregnancy test, which is negative. Shayna declines chlamydia and gonorrhea testing, as she states that she and her husband are monogamous. 20 minutes of a 30 minute face-to-face visit with the clinician is spent providing counseling on PrEP used during conception and pregnancy. What codes would we use to bill for this visit?Ann Finn (29:06):Since Shayna has had her IUD removed here at the clinic three months ago, she is considered an established patient. The majority of her 30 minute face-to-face visit with the clinician was spent on counseling and was appropriately documented in the chart note, so the clinician selects E/M code 99214, based on the 30 minute visit. We would also want to include ICD-10 codes Z20.6, contact with and suspected exposure to HIV, since she is no longer using birth control and her partner is HIV positive, to support the services and tests provided today. Z79.899, for longterm current drug therapy, since she isn't taking PrEP for over 18 months. Z31.69 for the preconception counseling, and Z32.02 to support the negative pregnancy test. Since the CPT codes billed are not inherently preventative but fall under the USPSTF guidelines as grade A/B preventative, we would include the 33 modifier to avoid cost sharing as needed. We would also append a modifier 25 to the E/M to indicate separate and distinct from the blood draw to avoid payment denials. Check with your local payers on their requirements.Ann Finn (30:28):New York State Medicaid coding guidelines for PrEP includes this advice: always includes Z20.6 when coding PrEP visits. If an insurer requires additional coding, clarifying a patient's risk, Z20.2, sexual exposure risk, or F19.20, injection drug use exposure risk, can be added. These codes avoid the use of disease 72 codes that are considered as stigmatizing, because they indicate problems related to a lifestyle.Ann Finn (31:05):Since PrEP services typically involves significant counseling, we've included this table as a reference tool that outlines CPT guidelines for outpatient clinic visits, codes based on total face-to-face time between the clinician and patient. The number in parentheses is CPT's published typical time for each code, and we've added the applicable range of minutes to make it easy to use. Remember that visit 992 codes can be selected based on time if over 50% of the face-to-face time with the provider is spent on counseling and/or coordination of care.Ann Finn (31:43):We need to document both the total face-to-face time and the amount of time the clinician spent counseling with a note to support the counseling in the medical chart. Base the code on the total face-to-face time, not just the counseling time, to avoid undercoding and be underpaid. Most payers allow CPT guidelines which includes only the clinicians, the physician or mid-level provider's time, and does not include the time the nurse or medical assistant spends with the patient. Check with your payers, because there are some exceptions to this rule.Ann Finn (32:19):As Edwin discussed earlier, cost concerns may be a deterrent for accessing adherence to PrEP, so ensuring your claims are submitted without errors and within a payer's allowable timeframe is essential. Some kind of billing errors that we see that may cause a denial of payment include missing an incorrect demographic information on the claim causing the claim to not be processed, incorrect diagnosis codes that don't correspond to the services provided. Remember, accepted billing codes can vary from payer to payer, so it's important when you are beginning to bill for PrEP you clarify each of the payers requirements and accepted codes, such as Z20.6, contact with or suspected exposure to HIV.Ann Finn (33:05):A payer may have established frequency limits for the service that may require further explanation. And finally, modifier 33 was not correctly appended to the CPT code and was needed to tell the payer the service was preventive and without the cost sharing. Missing and incorrect modifiers can cause services to be both under and overpaid, and yet are often missed by untrained billing staff.Ann Finn (33:32):Follow up on any unresolved billing issues with your third party payer right away and ensure your staff is trained on how to correctly code and bill for PrEP services. We encourage you to download and to read through NASTAD's coding manual in full that we've been referring to today, to review other codes and guidance that may be applicable for billing for PrEP related services. I'm going to hand it back over to Edwin.Edwin Corbin-Gutierrez (33:57):Thank you, Ann. As I mentioned, with the recommendation of PrEP as an A grade preventive service, the US Preventive Services Task Force provided the strongest backing possible for providers across the country to integrate PrEP into routine care. The ACA mandates that private insurance plans and Medicaid expansion programs cover preventive services with the USPSTF A or B rating at no cost to the patient.Edwin Corbin-Gutierrez (34:26):In the case of PrEP, the USPSTF defined the population to be included in its recommendation in almost identical terms to the recommendation made in the US Public Health Service guidelines for PrEP. Health plans and Medicaid programs will be required to implement this new recommendation by January, 2021. However, state health insurance commissioners may request that health plans begin implementation immediately. Since quarterly clinical visits and lab tests are an integral part of PrEP and cannot be divorced from the medication, the recommendation should be implemented to cover these services as well as the medication.Edwin Corbin-Gutierrez (35:07):NASTAD and the Federal AIDS Policy Partnership continue to advocate for this to be the case. Providers are encouraged to report discriminatory practices to their state insurance commissioner, including the use of prior authorizations and other cost management strategies that create unacceptable barriers to coverage.Edwin Corbin-Gutierrez (35:27):Finally, we want to share some helpful resources. We've mentioned NASTAD's billing coding guide, which is available to download through the resources as part of the webinar. You might also want to review NASTAD's Financing HIV Prevention white paper for innovative contracting opportunities. A PrEP health plan assessment tool, , is also available online. The STD Training and Technical Assistance Center also has great resources on this topic. Prep copay assistance programs and copay accumulator policies are listed on NASTAD's PrEP cost resources page. We reference the US Public Health Service PrEP guidelines, which include a helpful clinical providers’ supplement.Edwin Corbin-Gutierrez (36:12):The New York State Department of Health code sheet is also available, and we reference the New York City recommended ICD-10 codes, two great resources that detail the codes recommended by the two health departments. You can sign up for updates using the QR code, and email us with questions at ecg@.NCTCFP (36:34):You may also find additional PrEP resources through the Office of Population Affairs, such as the PrEP decision-making guide, and CTCFP, as well as our sister organization has additional PrEP resources, as well as our sister organization, the FPNTC. Thank you so much for joining our virtual coffee break today, and we hope that you will join us next time. ................
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