Does this law impact access to Medicaid, Medicare or other insurance reimbursement HIV counseling and testing?
No. Reimbursement mechanisms were not impacted directly by the law. However, changes do occur. For instance, the NYSDOH released the following guidance in late October 2010: It is anticipated that the HIV Primary Care Medicaid Program’s HIV Testing Visits will be subsumed into the Department’s Ambulatory Patient Groups (APGs) Methodology effective January 1, 2011. At that time, HIV Primary Care Medicaid Program (HPCMP) participants should no longer use the currently carved out rate codes – unless the provider is a Federally Qualified Health Center and has opted out of APG’s. HIV counseling that occurs in conjunction with a medical visit is a billable service when a physician or other qualified health care professional spends time with the patient to discuss at some length topics including but not limited to HIV disease, the importance of testing, and risk factor reduction. Billing for such counseling services is through one of the CPT codes for “Preventive Medicine, Individual Counseli
