ForwardHealth reimburses family planning clinics for HCPCS procedure code H1010 (Non-medical family planning education, per session) for the non-medical family planning education clinics provide with nearly all drugs and supplies they dispense.
Providers may submit claims with procedure code H1010 when a health care professional or paraprofessional, including a clinic aide, provides education with the dispensing of a drug and/or supply. Since family planning education is included in a preventive medicine visit (i.e., CPT procedure codes 99384–99387 and 99394–99397) providers may not bill procedure code H1010 with a preventive medicine visit. Procedure code H1010 is allowable once per member (i.e., one unit), per DOS, per provider. Family planning education is covered only when provided one-on-one, in a face-to-face session between the provider and the member. Providers are required to retain documentation in accordance with Wis. Admin. Code § DHS 106.02(9).