99385 Insurance Policy Changes

CPT 99385, in plain terms, covers A preventive health checkup for a new patient between ages 18 and 39. CPT 99385 is referenced in 29 tracked payer policy changes from Harvard Pilgrim Health Care, New Mexico Medicaid, and 15 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 99385 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 99385 on AAPC