Skip Navigation LinksADAP_MM_2024-03_Updated_Allowable_Medical_Services_and_Reimbursement_Rates ADAP MM 2024-03 Updated Allowable Medical Services and Reimbursement Rates

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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


ADAP MM 2024-03
March 11, 2024


TO:
ADAP Enrollment Workers and PrEP-AP Clinical Providers

SUBJECT:
Updated ADAP Allowable Medical Services and Reimbursement Rates

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​ADAP MM 2024-03: Updated ADAP Allowable Medical Services and Reimbursement Rates


​Overview

The purpose of this memo is to notify AIDS Drug Assistance Program (ADAP) Enrollment Workers and PrEP-AP Clinical Providers of updates to the Allowable ADAP Related Medical Services. The Allowable ADAP Related Medical Services describes services for which patient out-of-pocket costs can be billed to ADAP's medical benefits manager, Pool Administrators, Inc. (PAI). It also includes relevant Current Procedural Terminology (CPT) codes, reimbursement rates for services, and HIV related International Classification of Diseases, Tenth Revision (ICD-10) codes.

CPT Code Updates

The following CPT codes have been added to the Allowable ADAP Related Medical Services list​ effective February 19, 2024:

  • 90472 – Immunization Administration
  • 90473 – Immunization Administration
  • 90474 – Immunization Administration

Reimbursement Rate Updates

The Allowable ADAP Related Medical Services list has been updated to reflect the current Medicare reimbursement rate for all services. The updated reimbursement rates go into effect on February 19, 2024. 

ADAP requests that you share this information with your clinical and leadership teams.

If you have any questions regarding the information provided in this memo, please contact your OA Advisor.


Thank you,

Joseph Lagrama Signature.png

Joseph Lagrama
ADAP Branch Chief 
California Department of Public Health