H2040 Coord specialty care, month
Also known as: care coordination, specialty coordination, case management
Specialty care coordination service covering coordination of medical and behavioral health services for one calendar month.
In Plain Language
help organizing your medical and mental health care; coordination of different doctors and services
Clinical Context
Comprehensive coordination of multiple specialty services and providers for individuals with complex medical and behavioral health needs. Monthly administrative fee per beneficiary.
RVU Information
CPT H2040 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
This HCPCS code requires documentation of medical necessity and a valid physician order. Coverage and reimbursement policies vary by payer. Check with the specific insurer for prior authorization requirements.
Specialties
Frequently Asked Questions
What is CPT code H2040?
CPT H2040 (Coord specialty care, month) is a Other HCPCS code. Specialty care coordination service covering coordination of medical and behavioral health services for one calendar month.
Does Medicare cover H2040?
Medicare coverage for H2040 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Comprehensive coordination of multiple specialty services and providers for individuals with complex medical and behavioral health needs. Monthly administrative fee per beneficiary. A physician order is typically required.
When is CPT H2040 used?
Comprehensive coordination of multiple specialty services and providers for individuals with complex medical and behavioral health needs. Monthly administrative fee per beneficiary.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.