2012 CPT® codes paid by Ohio Medicaid with GE modifier

Have yet another area to define. What CPT® codes are paid by Ohio Medicare under the primary exception with modifier GE for 2012?

The statute under Ohio law looks like it was last reviewed in 2006. It lists CPT: 99201-99203, 99211-99213 and preventive codes 99381-99384(new) and 99391-99395 (est) but does not include HCPCS codes G0402, G0438 and G0439.
I am unable to locate a 2012 Ohio Medicaid update of preventive codes paid.

Nancy - do you have a source I can use?

Thanks,
Carole

re: 2012 CPT® codes paid by Ohio Medicaid with GE modifier

I would think that they followed Medicare's codes but can't find a recent source:
Medicare may grant a primary care exception within an approved GME Program in which you, the teaching physician, are paid for certain E/M services the resident performs when you are not present. The lower- and mid-level E/M services included under the primary care exception are shown below.
New Patient Established Patient
CPT® Code 99201 CPT® Code 99211
CPT® Code 99202 CPT® Code 99212
CPT® Code 99203 CPT® Code 99213
The Healthcare Common Procedure Coding System (HCPCS) codes included under the primary care exception are shown below.
HCPCS Code G0402 Initial preventive physical examination; face-to-face visit services limited to new beneficiary during the first 12 months of Medicare enrollment (effective January 1, 2005)
HCPCS Code G0438 Annual wellness visit, including personal preventive plan service, first visit (effective January 1,2011)
HCPCS Code G0439 Annual wellness visit, including personal preventive plan service, subsequent visit (effective January 1, 2011)
If codes other than the ones listed above are billed with the GE modifier, the services will be returned as Unprocessable.

re: 2012 CPT® codes paid by Ohio Medicaid with GE modifier

Thank you so very much. I got thrown by the new and established preventive care codes noted on the Ohio statute for Physician's service (99381-99384 and 99391-99394). I was under the understanding that these could not be used; just the 3 G codes for preventive along with the lower level new and established EM codes. Just could NOT find anywhere to confirm. Your reply did the job!!

Carole

re: 2012 CPT® codes paid by Ohio Medicaid with GE modifier

Great