Overview
The purpose of this memo is to inform Pre-Exposure Prophylaxis Assistance Program (PrEP-AP) Clinical Providers (CPs) of policy updates regarding PrEP-AP’s allowable PrEP-related laboratory reimbursement rates.
The
Allowable PrEP Related Medical Services document outlines the services for which patient out-of-pocket costs may be billed to PrEP-AP’s medical benefits manager, Pool Administrators, Inc. (PAI). This document includes relevant Current Procedural Terminology (CPT) codes, reimbursement rates, and PrEP-related International Classification of Diseases, Tenth Revision (ICD-10) codes.
Effective June 26, 2026, PrEP-AP will implement updated capped laboratory reimbursement rates. These adjustments reflect routine rate updates for the 2026 calendar year.
Clinical Providers are encouraged to review the updated reimbursement schedule in the Allowable PrEP Related Medical Services document and ensure that billing practices align with the revised rates. For questions or additional guidance, please contact the PrEP-AP Support Team at
PrEP.Support@cdph.ca.gov
The updated rates are listed below.
| CPT Code | Service Description | Reimbursement Rate |
| 87593 | MPX Testing | $ 76.96 |
| 86317 | Test - Hepatitis | $ 22.49 |
| 77080 | Assess bone health | $ 39.41
|
PrEP-AP requests that you share this information with your clinical and leadership teams.
If you have any questions regarding the information provided in this memo, or if you would like to request the addition of new services or labs, please contact PrEP-AP at PrEP.Support@cdph.ca.gov.
Thank you,
Joseph Lagrama
ADAP Branch Chief
California Department of Public Health