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It seems like a lot of labs to be completed at the same visit. 6n,l7a3pi)>0[R`^CN-p# u`(]pMF[Xh1/2 0000008060 00000 n
It is not to be used in place of CPT code 86141, which is the correct CPT code for hsCRP addressed in this LCD. D(*)6rt H2AF{@0L);0eI7Ek&66ic `D`?#|8jx)dx_`:W howE|`X7cLyeYx&4,]-rX"SXXF`Mf[jL7\TWfH45ZcVO PxLDFh8^"LSW1R ASh@:W@)t"AUDX$&3d$. The Medicare program provides limited benefits for outpatient prescription drugs. 2023 Laboratory Corporation of America Holdings. For the purposes of this policy, a facility POS is considered POS 19, 21, 22, 23, 26, 34, 51 . Some articles contain a large number of codes. U0001 . By clicking below on the button labeled "I accept", you hereby acknowledge that you have read, understood and agreed to all terms and conditions set forth in this agreement. Enjoy a guided tour of FindACode's many features and tools. CPT code information is copyright by the AMA. You are leaving the Horizon Blue Cross Blue Shield of New Jersey website. Code . Medical CPT codes are critical to streamlining reporting and increasing accuracy and efficiency, as well as for administrative purposes such as claims processing and developing guid .Read More Related Topic: CPT Catalog of Topics Local Coverage Articles are a type of educational document published by the Medicare Administrative Contractors (MACs). Type a procedure or code and select one from the list. Learn how to get the most out of your subscription. View a table of UCR, Worker's Comp, and Medicare Fees here, as well as see UCR Fees in the charts below. endstream
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code. Complete absence of all Bill Types indicates
A claim submitted for payment of a test on a local or national listwithout a specific diagnosis code that indicates medical necessity based upon the local or national policieswill result in denial of payment for these services. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). CRP is a pentameric globulin with mobility near the zone. 0000010403 00000 n
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87186 - Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [MIC] or breakpoint), each multi-antimicrobial . 0000010576 00000 n
You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. 86707 4 0 obj
Please click Continue to leave this website. View the CPT code's corresponding procedural code and DRG. 0000004072 00000 n
Reimbursement Policies & Guidelines Modifier 25 Lab codes when billed with other services These laboratory procedure codes may not be considered for separate reimbursement when submitted on outpatient claims if other non-laboratory procedure codes are billed for the same date of service. For clinical responsibility, terminology, tips and additional info start codify free trial. Get timely coding industry updates, webinar notices, product discounts and special offers. For unlisted code 80299, a description must be provided on the claim describing the therapeutic drug which is being quantifie d. (CPT guidelines for unlisted code reporting) e. CPT code 80299 <>
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of the Medicare program. Could really use some help in understanding when screening codes can be used. 82570 CPT 88344 %PDF-1.7
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This information does not take precedence over NCCI edits. Keep this table handy to apply new modifiers JK and JL correctly starting in May. 2 0 obj
Use 80305 - 80307, G0480 - G0483, G0659 instead. r gQRYs8Wsix-,z"EdC9u
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Arkansas Colorado Louisiana Mississippi New Mexico Oklahoma Texas, Jurisdiction J Beginning in 2018, lab service pricing is no longer adjusted based on geographic area. Please review and accept the agreements in order to view Medicare Coverage documents, which may include licensed information and codes. Current Dental Terminology © 2022 American Dental Association. Medicare is establishing the following limited coverage for CPT/HCPCS codes: 86141. 80061 (Press Enter or Space to Go to Landing Page or Press Down to expand Menu), Federally Qualified Health Centers (FQHCs), C-Reactive Protein (CRP), High Sensitivity (Cardiac Risk Assessment), Combatting Modern Slavery and Human Trafficking Statement. Connecticut Maine New Hampshire New York Rhode Island Vermont, Jurisdiction L View matching HCPCS Level II codes and their definitions. 86706 Draft articles are articles written in support of a Proposed LCD. CRP arises as a nonspecific response to tissue injury and inflammation. . Now you will have to bill using regular office visit codes and hospital admit codes. For clinical responsibility, terminology, tips and additional info start codify free trial. 0000005014 00000 n
will not infringe on privately owned rights. The Laboratory MUST process the Blue top tubes, within 4 hours of blood collection. Coding and Billing guidelines are available to facilitate reimbursement. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
If you would like to extend your session, you may select the Continue Button. Medicare 59 Modifiers- XE,XP,X2,XU. BQb#ecm1=8}'hJCrcC]k m2K]hYGqg=Xcw0\`:Wc^24]y.eB]8=JkrV=-8}n-p3dWKtemAMP K`~h` KG+ n~ wyRei$NCLm^:Gfq?]lT2v%ca;Wc>akXXmCC@fA}%[>Ei Nxom^G\2G$Z?W{c?*&?F_UJ? >YJ'vRUi/#-6Z~Bd apply equally to all claims. If you are looking for a specific code, use your browser's Find function (Ctrl-F) to quickly locate the code in the article. 1R:y8gmeQy(ECB)@}FM"f'71dj-P?PKQBJ"K+8*lkti:&$y
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LSx4-X8'aPe`[X(eb`m I was under the impression that they can only be used during a preventive care visit. APC information including: Status Indicator, Relative Weight, Payment Rate, Crosswalks, and more. ), Related CPT CodeBook Guidelines (Reverse Guideline Lookup). 0000007661 00000 n
The lab analyst performs the technical lab test to analyze the specimen, such as serum, for high sensitivity C reactive protein, hsCRP. :cF7v/(^;2lXrk13[tilEwFCO@jo4-}N(Y &rX(d
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kE"[&n:J%d2hIsuV"g>$S6IJe8 As used herein, "you" and "your" refer to you and any organization on behalf of which you are acting. Coding Information CPT/HCPCS Codes Expand All | Collapse All Group 1 (1 Code) It is the providers responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted. Also, you can decide how often you want to get updates. What You Need To Know. Or, if you would like to remain in the current site, click Cancel. complete information, CMS does not guarantee that there are no errors in the information displayed on this web site. The service is medically necessary. 0000009789 00000 n
You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. 512 0 obj<>
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All those not listed under the ICD-10 Codes that Support Medical Necessity section of this article. The Current Procedural Terminology (CPT ) code 86141 as maintained by American Medical Association, is a medical procedural code under the range - Qualitative or Semiquantitative Immunoassays. 83036 0000007485 00000 n
CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. "JavaScript" disabled. The American Hospital Association ("the AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. 0000008017 00000 n
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Therefore, if a drug is self-administered by more than 50 percent of Medicare beneficiaries, the drug is excluded from coverage" and the MAC will make no payment for the drug. an effective method to share Articles that Medicare contractors develop. 86140; 84311; 83516 86140; 83516 LAB43 ACTMN Acetaminophen 80307 80143 LAB34 SALIC Salicylate 80307 80179 All Rights Reserved. Illinois Minnesota Wisconsin, Jurisdiction E VIDEO - Medicare consultation codes have been eliminated.
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Due to system changes, the order of the Coding Section has been revised and new sections for CPT/HCPCS Modifiers and Other Coding Information have been added. Billing and Coding articles provide guidance for the related Local Coverage Determination (LCD) and assist providers in submitting correct claims for payment. MACs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims. Cancel anytime. Below you will find cost information associated with this procedure based upon the a set of publicly available data which details all doctors who billed Medicare for this code. xYnF}7G6\.I{IF%-R)pI9)iMH\YWWo?1;z`g+XKc_WWx.SSjQ{k!]s'{{8 Or|gga
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1`? This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphatase, alkaline (84075) Potassium (84132) Protein, total (84155) Sodium (84295) Transferase, alanine amino (ALT) (SGPT) (84460) HWv6)% %BN;3vB4$-M_d@YKT$q$s(>O|<8STb-05n,ru|v(%_ol@|!`5.Iuq#04a>>T:a3>$C;..2YOa8"yHyp`ZVKA%ED(mC %&' !l8`QNz5-S3;4"&}(M;\VXEWuyG7_*yJo|F{]lZGw${U]1$XuG7J0.y.9l,83Yj9L0F\l$ ]H^zwnb5N)/se. You can use the Contents side panel to help navigate the various sections. Please help me understand. damages arising out of the use of such information, product, or process. Articles often contain coding or other guidelines that are related to a Local Coverage Determination (LCD). B9[0Lh>@9\KL4 K+]d`i4
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$n=cCZaE@R The Medicare program will allow the laboratory to bill the patient for denied LCD/NCD coverage services only if anAdvance Beneficiary Notice of Non-coverage (ABN)is completed, signed and dated by the patient prior to service being rendered, and forwarded to the laboratory prior to testing. View a chart showing the last 8+ years of Medicare denial rates, Medicare Allowed amounts, and Medicare billed amounts. 87088 - Culture, bacterial; with isolation and presumptive identification of each isolate, urine. :p-XEo\ubnbKeX]3MWW4nmin4JcDb/=ib3Q^z$ 12B#XR8@n`UBg{Ok>>7?4'l
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""m? Please refer to NCCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare. To ensure the accurate and appropriate use of the information, it is recommended that the Medicare Administrative Contractor be consulted. 0000007794 00000 n
GOVERNMENT AND ITS EMPLOYEES ARE NOT LIABLE FOR ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION, PRODUCT, OR PROCESSES
This website does not display all Qualified Health Plans available through Get Covered NJ. CRP is an acute phase reactant, which can be used as a test for inflammatory diseases, infections, and neoplastic diseases. These codes should not be used to report urine drug testing for illicit use of these drugs. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. Consistent with CMS Change Request 10901, all coding information from the related LCD has been placed into this article. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. See our privacy policy. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. I was just wondering if any are bundled. The Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) code(s) may be subject to National Correct Coding Initiative (NCCI) edits. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. 84443 Currently, CRP (CPT code 86140) is covered as a diagnostic test for the detection and evaluation of infection, tissue injury and inflammatory disease, not involving atherosclerosis of the arteries. and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only
0000009656 00000 n
b.3F(OibD9-jfcl5L1eQ?&t~|k|5i!**Qx)5@ For FREE Trial. inI$.n[Mdce'a)cw 1K{_W |Z)Qpu,;
3 H?*YlwgegRK}T~#l?^1?hj_Z mQ Iq*,{f_sHx 86140 HOo |9f\TmLx;*zTY?zc4vl aL$\8lpw`\?up]Iq0!SPj0#q m`mF`,Z=%L!j5Z )q.8>S,ny/1SC}GXv]4*RpB-y 1oWKB.I:i]A0d KyEm+l6}1C"iSYjSzY(UJTo;T_ / While every effort has been made to provide accurate and
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In a click, check the DRG's IPPS allowable, length of stay, and more. Not offered in Quest Diagnostics Nichols Institute (IFD) - San Juan Capistrano. Medicaid and the State Children's Health Insurance Programs, contracts with certain organizations to assist in the administration
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It is an acute phase reactant which rises rapidly, but nonspecifically in response to tissue injury and inflammation. An official website of the United States government. 0000008858 00000 n
Instructions for enabling "JavaScript" can be found here. 2018 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2016 American Medical Association. Labs & Appointments Toggle Labs & Appointments, Billing & Insurance Toggle Billing & Insurance, Diseases & Conditions Toggle Diseases & Conditions, OnDemand Testing Toggle OnDemand Testing, Testing by Disease & Condition Toggle Testing by Disease & Condition, Testing & Services For Toggle Testing & Services For, Hospitals & Physician Systems Toggle Hospitals & Physician Systems, Managed Care Health Plans Toggle Managed Care Health Plans, Lab Data Integrations & Tools Toggle Lab Data Integrations & Tools, Employee Wellness & Testing Toggle Employee Wellness & Testing, Government & Education Toggle Government & Education, Therapeutic Indications Toggle Therapeutic Indications, Development Phase Toggle Development Phase, Compounds & Molecules Toggle Compounds & Molecules, Quantitative concentration of CRP (mg/L) in serum. The CPT Code 86140 is the code used for Pathology and Laboratory / immunology. 0000004792 00000 n
Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. 86140 - CPT Code in category: C-reactive protein CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more. 87350 Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license. 0000009523 00000 n
0000008725 00000 n
Description Obs Mean Std Dev C.V. 5th 25th 50th 75th 95th IQR PM Pts . Please do not use this feature to contact CMS. 0000008991 00000 n
Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense Federal Acquisition Regulation supplement (DFARS) Restrictions Apply to Government Use. You can use your browser's Print function (Ctrl-P on a PC or Command-P on a Mac) to view a print preview and then select PDF as the output. Description Microalbumin is the quantification of small amounts of albumin, a serum protein, in urine that can be used to identify . [f,A:S[B]-"0BDE*j@qo9cc[9GFf{|(#.U8x&"BgfPP4596y6#eS*Z Request a Demo 14 Day Free Trial Buy Now Additional/Related Information Lay Term DISCLOSED HEREIN. C-Reactive Protein (CRP) Test Code 4420 86140 Ordering Restrictions may apply. ]@$b0e%a^HVBXH{x'%RK Frequency Limitations Consistent with the related LCD, no more than 3 services of CPT code 86141 may be reported per patients lifetime. In a click, check the DRG's IPPS allowable, length of stay, and more. used to report this service. |(U1*#
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Uo For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. A lipid panel (CPT code 80061) at a yearly interval will usually be adequate while measurement of the serum total cholesterol (CPT code 82465) or a measured LDL (CPT code 83721) should suffice for interim visits if the patient does not have hypertriglyceridemia (for example, ICD-9-CM code 272.1, Pure hyperglyceridemia). THE UNITED STATES
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The CPT codes included in this publication are in accordance with Current Procedural Terminology, a publication of the American Medical Association. To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom
Refer to the Novitas Local Coverage Determination (LCD) L34856, C-Reactive Protein High Sensitivity Testing (hsCRP), for reasonable and necessary requirements and frequency limitations. reimbursement policies may use Current Procedural Terminology (CPT*), Centers for Medicare and Medicaid Services (CMS) or other coding guidelines. /!Q4JE004(D1e1&F`"ld| Revenue Codes are equally subject to this coverage determination. Response to Comment (RTC) articles list issues raised by external stakeholders during the Proposed LCD comment period. 0000007884 00000 n
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The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product.
iC%I%o|_mk{dLk=.hQIU6!&77LNR 0000007318 00000 n
For J.D. CPT: 86140 Print Share Include LOINC in print Test Includes Quantitative concentration of CRP (mg/L) in serum Expected Turnaround Time Within 1 day Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. 87077 View any code changes for 2023 as well as historical information on code creation and revision. Available for over 5000 of the most common CPT codes. accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the
If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816. These codes will only be considered for separate reimbursement if they are the only service billed for a date of service or if they are billed ONLY with other laboratory procedure codes for the same date of service. Note: Use ICD-10-CM code Z74.09 and Z78.9 for patients at intermediate risk for CAD who do not have elevated lipids (i.e., do not meet criteria to use ICD-10-CM codes E78.00-E78.3 or E78.49). The general guidance for this code is that it is used for measurement c-reactive protein for detection of infection or inflammation. not endorsed by the AHA or any of its affiliates. 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Antipsychotics (APM), Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP), Follow-Up After Emergency Department Visit for Substance Use (FUA), Follow-Up After Hospitalization for Mental Illness (FUH), Follow-Up After High-Intensity Care for Substance Use Disorder (FUI), Follow-Up After Emergency Department Visit for Mental Illness (FUM), Initiation and Engagement of Substance Use Disorder Dependence Treatment (IET), Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA), Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD), Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia (SMC), Diabetes Monitoring for People with Diabetes and Schizophrenia (SMD), HEDIS Measurement Year (MY) 2023 Provider Tips for Optimizing HEDIS Results, Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA), Adults Access to Preventive/Ambulatory Health Services (AAP), Antibiotic Utilization for Respiratory Conditions (AXR), Appropriate Testing for Children with Pharyngitis (CWP), Appropriate Treatment for Upper Respiratory Infection (URI), Avoidance of Antibiotic Treatment for Acute Bronchitis/ Bronchiolitis (AAB), Blood Pressure Control for Patients With Diabetes (BPD), Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC), Child and Adolescent Well-Care Visits (WCV), Childhood Immunization Status (CIS) (CIS-E), Colorectal Cancer Screening (COL) (COL-E), Deprescribing of Benzodiazepines in Older Adults (DBO), Depression Remission or Response for Adolescents and Adults (DRR-E), Depression Screening and Follow-Up for Adolescents and Adults (DSF-E), Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD), Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD), Eye Exam for Patients With Diabetes (EED), Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA), Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions (FMC), Follow-Up After High- Intensity Care for Substance Use Disorder (FUI), Follow-Up Care for Children Prescribed ADHD Medication (ADD-E), Hemoglobin A1c Control for Patients With Diabetes (HBD), Immunizations for Adolescents (IMA) (IMA-E), Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET), Kidney Health Evaluation for Patients with Diabetes (KED), Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-E), Osteoporosis Management in Women Who Had a Fracture (OMW), Osteoporosis Screening in Older Women (OSW), Persistence of Beta- Blocker Treatment After a Heart Attack (PBH), Pharmacotherapy Management of COPD Exacerbation (PCE), Postpartum Depression Screening and Follow-Up (PDS-E), Prenatal Depression Screening and Follow-Up (PND-E), Statin Therapy for Patients with Cardiovascular Disease (SPC), Statin Therapy for Patients with Diabetes (SPD), Unhealthy Alcohol Use Screening and Follow-Up (ASF-E), Use of Imaging Studies for Low Back Pain (LBP), Use of Opioids from Multiple Providers (UOP), Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR), Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS-E), Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC), Well-Child Visits in the First 30 Months of Life (W30), Policies, Procedures and General Guidelines, Programs Administered by eviCore healthcare, Participating Physician and Other Health Care Professional Office Manual, Behavioral Health Network Specialist Assignments, Eligibility and Benefits Cost Share Estimator, Womens Health Results and Recognition Program, Provider Guidelines: Non-Standard (Medical Record) Supplemental Data for HEDIS Gap Closure, How to Submit Supplemental Data to Horizon, Health Outcomes Survey: How You Can Drive Results, Radiation Therapy Medical Necessity Determination, Pregnancy-Newborn Episodes of Care Program: Helping to Improve Outcomes for Moms and Newborns, As Mental Health Needs Continue To Rise, So Do Innovative Virtual Services, Treat Knee, Back, and Hip Pain with Orthotic Device that Helps Avoid Invasive Procedures, Horizon Neighbors in Health Program Supports Struggling Families, Bariatric Surgery Value-Based Program Helps Members with Weight Loss, Dental Providers Benefit from Dedicated Horizon Liaisons, Connecting with parents on the importance of early childhood health screenings and vaccinations, Episodes of Care Program Gives Cancer Patients the Care They Need, HealthSphere gives a behavioral health provider the full patient view, Home-Delivered Meals Help Braven Health℠ Patients, Horizon Neighbors in Health Program Helps At-Risk Members in Camden, How a value-based primary care provider helps the New Jersey Vaccination Program, Improving Health Equity through Increased Access to Prenatal Care Across New Jersey, Making Pathways in Innovating and Advancing Maternal Health, Pharmacy Collaboration leads to better patient outcomes and cost savings, Providing Innovative Cancer Care - Expanding Episodes of Care, Telehealth after COVID-19 Many doctors agree it's here to stay, Value-based care -- transforming health care with better collaboration and improved health outcomes, When planning, collaboration and crisis merge - a medical practice's successful response to COVID-19, Applicable Products:Commercial PPO/EPO &Exchange POS/EPO, Applicable Products: Commercial HMO & POS, Claims Payment Policies and Other Information.