Quality Incentive Adjustments Coming October 1, 2024
Date: 08/22/24
Beginning October 1, 2024, our quality incentives will be adjusted for all in-network providers as noted below. This adjustment is designed to coordinate with statewide efforts to improve Louisiana's health on specific quality measures, and incorporates feedback from our provider network.
Early detection and preventive care are crucial strategies for improving the health outcomes of Louisiana’s citizens, and physicians like you play a key role in driving that strategy. That’s why we pay healthcare practitioners a quality bonus when they provide our members with needed services, like screenings for child and adolescent well-care, cervical cancer, Hepatitis C, colorectal cancer, STIs, follow up after certain emergency department visits and more.
Thank you for all you do to promote preventive care and early detection. We are happy to enclose with this letter:
- A full list of incentivized services, CPT codes and quality bonus amounts
- Detailed reports about your quality bonus payment, as well as other quality measures, are available on the secure provider portal (https://provider.louisianahealthconnect.com).
Thank you for your efforts for early detection and preventive care among your patients – our members. We value your partnership in transforming Louisiana’s health, one person at a time.
If you have any questions, please don’t hesitate to contact your dedicated Provider Engagement Administrator or call Provider Services at 1-866-595-8133.
2024 Incentive Measures | Procedure Code | Amount |
|---|---|---|
Cervical Cancer Screening (CCS) | 87624, 87625, 88141, 88142, 88143, 88147, 88148, 88150, 88152, 88164, 88174, 88175 | $20.00 |
Child and Adolescent Well-Care Visits (WCV) | 99382, 99383, 99384, 99385, 99391, 99392, 99393, 99394, 99395, 99461, G0438, G0439, S0610, S0612 | $10.00 |
Colorectal Cancer Screening (COL) | 44389, 44392, 44394, 44404, 44405, 45330, 45331, 45332, 45333, 45334, 45335, 45337, 45338, 45340, 45341, 45342, 45349, 45350, 45378, 45379, 45380, 45381, 45382, 45384, 45385, 45386, 45388, 45389, 45390, 45391, 45392, 45393, 45398, 74261, 74262, 74263, 81528, 82270, 82274 | $50.00 |
Controlling High Blood Pressure (CBP) | 3074F, 3075F, 3079F | $10.00 |
Developmental Behavioral Screening (EPSDT) | 96110 | $10.00 |
Topical Fluoride Varnish (TFV) | 99188 | $10.00 |
Follow-up After Emergency Department Visit for Mental Illness (FUM) | 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90847, 90849, 90853, 90875, 98960, 98961, 98967, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99241, 99242, 99243, 99244, 99245, 99251, 99252, 99253, 99254, 99255, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99441, 99442, 99443, 99483, 99495, 99496, 99510 | $25.00 |
Follow-up After Emergency Department Visit for Substance Abuse (FUA) | 98960, 98961, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99408 | $25.00 |
Follow-up After Hospitalization for Mental Illness (FUH) | 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90847, 90849, 90853, 90875, 98960, 98961, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99221, 99222, 99223, 99231, 99233, 99234, 99238, 99239, 99241, 99242, 99243, 99244, 99245, 99251, 99252, 99253, 99254, 99255, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99383, 99384, 99385, 99386, 99387, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, | $25.00 |
Glycemic Status Assessment for Patients with Diabetes (GSD) | 3044F, 3051F | $10.00 |
Hepatitis C Virus (HCV) Testing | 86803, 86804, 87520, 87521, 87522 | $5.00 |
Human Papillomavirus (HPV) Vaccine | 90649, 90650, 90651 | $15.00 |
Influenza Vaccine (FLU) up to 21 years old | 90655, 90657, 90660, 90661, 90662, 90672, 90674, 90685, 90686, 90687, 90688, G0008 | $20.00 |
Post-Partum Care (PPC) | 0503F, 59430 | $50.00 |
Syphilis (SYPH) Testing | 86592 | $5.00 |
Human Immunodeficiency Virus (HIV) Testing | 86703, 87389 | $5.00 |
Hepatitis BsAg (HBV) Testing | 87340 | $5.00 |
Chlamydia (CT) Testing | 87491 | $5.00 |
Gonorrhea (GC) Testing | 87591 | $5.00 |
Notification of Pregnancy (NOP) | *NOP forms available at www.louisianahealthconnect.com | $75.00 |
Body Mass Index Percentage (BMI) | Will pay per CPT/Diagnosis combination; in order to get paid the service line must have one of the following CPT codes coupled with one of the following Diagnosis codes CPT Codes = 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99381, 99382, 99383, 99384, 99385, 99391, 99392, 99393, 99394, 99395, 99396 Diagnosis Codes = Z6851, Z6852, Z6853, Z6854
| $5.00 |
Social Determinants of Health (SDOH) | Will pay per CPT/Diagnosis combination; in order to get paid the service line must have one of the following CPT codes coupled with one of the following Diagnosis codes CPT Codes = 96160 Diagnosis Codes = Z55, Z59, Z65, Z590, Z591, Z594, Z598, Z139 | $5.00 |
This notice was updated on 8/23/24 to correct an error to the procedure codes for Child and Adolescent Well-Care Visits (WCV).