NY Medicaid: Category II CPT® Codes Required for Prenatal and Postpartum Services

For Providers of UnitedHealthcare Community Plan in New York

Important Notice: When submitting claims for prenatal or postpartum services, include a Category II CPT code alongside global or bundled billing codes. Use one of these Category II codes as appropriate:

• 0500F: First prenatal appointment
• 0502F: Follow-up prenatal appointment
• 0503F: Postpartum appointment

Purpose of Category II CPT Codes

Incorporating Category II CPT codes in your claims supports adherence to the prenatal and
postpartum care standards set by the New York State Department of Health.

How to Submit a Claim

Claims can be submitted via the UnitedHealthcare Provider Portal:

• Visit UHCprovider.com and select Sign In at the top-right.
• Log in with your One Healthcare ID.
• Navigate to Claims & Payments > Submit a Claim.
• Fill in the required fields, attach any supporting documents, and submit.

Additional Resources

• American Medical Association Category II Codes: Explore updates, new additions, and a comprehensive list of clinical topics and conditions related to CPT Category II codes.
• Claims Submission Guide: Discover step-by-step instructions for submitting electronic claims (professional or facility/institutional) without an EDI clearinghouse.