S0280 Medical home, initial plan
Also known as: medical home initial, care plan development
Medical home service, initial care plan development. Physician-led comprehensive assessment and creation of care management plan.
In Plain Language
health management plan setup; comprehensive care planning
Clinical Context
Structured service in primary care medical home model establishing baseline health status, identifying care needs, and developing individualized comprehensive care plan for complex patients.
RVU Information
CPT S0280 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
S-codes are used by private payers (not Medicare) for services without a standard CPT or HCPCS code. Coverage varies significantly between insurers. Verify payer acceptance before billing and document medical necessity thoroughly.
Specialties
Frequently Asked Questions
What is CPT code S0280?
CPT S0280 (Medical home, initial plan) is a S Codes code. Medical home service, initial care plan development. Physician-led comprehensive assessment and creation of care management plan.
Is S0280 covered by insurance?
S0280 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Structured service in primary care medical home model establishing baseline health status, identifying care needs, and developing individualized comprehensive care plan for complex patients.
When is CPT S0280 used?
Structured service in primary care medical home model establishing baseline health status, identifying care needs, and developing individualized comprehensive care plan for complex patients.
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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.