Wiki emergency Contraception Pill CPT Code

[jbhuju]

hello,
just wondering which CPt code to use for emergency contraception pills . Do we use S4993? and what would we charge? please help.

 

[CBLENNIE]

Typically, health insurance plans are not going to cover emergency contraceptive pills under the major medical benefits because it is an over-the-counter medication. If it is covered by a patient's health insurance plan, it will likely be covered under their pharmacy benefit plan. The insurance company I work for would deny S4993 indicating that the claim needs to be submitted to the patient's pharmacy benefits manager (PBM).