Private-Payer-Advocacy-Letters-to-Carriers

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Payer Advocacy: Letters to Carriers

 

 

 

Breastfeeding

• AAP Urges Carriers to Provide Consistent Benefits Coverage for Breastpumps​ (10/11/13) 
  

Cardiology and Vascular Related Issues

• ​Letter of Medical Necessity for Hemangiomas​

​​Children and Youth With Special Health Care Needs

• AAP Advocates for Expanded Benefits Coverage for Blood Glucose Monitoring (2/20/2015)
• Letter from AAP and Specialty Societies Advocating for Coverage for Vascular Anomalies

CPT Coding

• AAP Notifies Carriers of 2019 CMS Final Rule on New CPT Codes and E/M Documentation
  
• AAP Notifies Carriers of New CPT Codes for 2017 and Modifier 95
• Payers New CPT Codes​

Immunizations

• AAP Notifies Payers of Merck Vaccine Price Increase​ (September 2016)
• AAP Notifies Carriers of Updated HPV Vaccine Recommendations (5/29/15)
• AAP Notifies Payers of Prevnar 13 Price Increase®
• ​​​Tricare Increases Number of Reported Units for Immunization Administration Codes, Enabling Increased Payment

Infliximab: AAP Works With Carriers to Clarify Coverage

• Letter Dated 4-29-2011​​

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​ Mental Health

• AAP Notifies Payers of CPT code 96127 (Emotional/Behavioral Assessment; Urges Appropriate Payment
  
• AAP Objects to Humana denials for developmental screening
• AAP Urges Payers to Enhance Coverage and Payment for Pediatric Mental Health
• Business Case: Improving Mental Health Services in Primary Care - A Call to Action for the Payer Community

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Oral Health

• AAP Notifies Payers of CPT Code 99188 for Fluoride Varnish Application; Urges Coverage and Payment
  
   
• AAP Notifies Carriers of Revised Recommendations for Flouride Varnish Application​

Preventive and Well Child Care

• Payment for Sick and Well Visits​
• AAP Notifies Payers on a New Visual System Assessment Recommendations​ (2-16-2016)
• AAP Notifies Carriers of Revised Guidelines for Palivizumab Prophylaxis

Smoking Cessation

• AAP Signatory in Letter to Carriers on Coverage for Smoking Cessation Counseling  (7/21/09)
  

Urology Related Issues

• ​Biofeedback
  
• Deflux
• Testicular Prosthesis​

 

Vision Screening and Assessment

• ​AAP Letter to Carriers on Instrument Based Screening​
  
• UHC Response Letter to AAP on Vision Based Screening ​

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