Passport Health Plan by Molina Healthcare policies
Search Passport Health Plan by Molina Healthcare's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.
5 policies name 99205, those listing the fewest codes first. A policy that names a code may also list it as excluded.
| Policy | Details | Codes | Source |
|---|---|---|---|
| Psychotherapy Add On with High Level EM | Commercial, Medicaid | 7 | Original policy ↗ |
| Psychotherapy Add-On with High Level E/M Policy | Effective Aug 21, 2025 · Medicaid | 7 | Original policy ↗ |
| High Level E/M with Preventive Medicine Policy | Medicaid · KY | 10 | Original policy ↗ |
| High Level Evaluation and Management with Preventive Medicine | Commercial | 10 | Original policy ↗ |
| High-Level Evaluation and Management with Preventive Medicine | 10 | Original policy ↗ |