Prior Auth Required

99078 - • with TH modifier – reimbursement is $30.00 per visit, up to 10 visits total

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service• with TH modifier – reimbursement is $30.00 per visit, up to 10 visits total
Procedure / Service Description

These services pay separately from global maternity benefits and should not be billed with an office visit (members - do not have any cost-share responsibility): • 99078 with TH modifier – reimbursement is $30.00 per visit, up to 10 visits total • 0502F – reimbursement is $175.00 as a one-time retention incentive on or after the fifth visit

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.