September 26, 2023

eStar update: hierarchical condition category best practice advisory changes

Beginning Sept. 26, the Hierarchical Condition Category best practice advisory (BPA) will change to “required” status if the provider adds an AWV or PE billing code to a visit.

If an Adult Wellness Visit or Physical Exam code is entered as an additional E/M code, or if the Level of service changes to an AWV or PE code, the Hierarchical Condition Category BPA will switch from ‘recommended’ to ‘required’ status.

Review the Using the HCC BPA – Ambulatory Provider tipsheet.