MedicaidBilling CodesMedium impact
Provider Letter 2024-08: RE: Human Immunodeficiency Virus (HIV) Counseling (OK SPA 23-0032)
Oklahoma SoonerCare·OK · Family Medicine, Internal Medicine, General Practice +2 more·Provider Letter
Effective date
May 7, 2024
We identified it
Jun 20, 2026
Summary
Oklahoma Medicaid now covers HIV counseling using CPT code 99401 at $33.55 for preventive counseling sessions of approximately 15 minutes. This applies to members age 10+ and can be billed once per year with specific documentation requirements including HIV education, risk factor identification, and risk reduction planning.
Action Required
Immediately: Billing team must add CPT code 99401 to billing system with rate $33.55 for Oklahoma Medicaid HIV counseling. Update encounter forms to include ICD-10 code Z71.7. Configure system to limit billing to once per year for ages 10+. Train providers on required documentation: HIV education, risk factors discussion, member-specific risk identification, and risk reduction planning. Enable GT modifier for telehealth sessions.