Maximizing Your Value-Based Payments using CPT Category II Coding Tip Sheet
CPT category II codes are used to measure performance on quality metrics in Healthcare Effectiveness Data and In¬formation Set (HEDIS), Care-Based Incen¬tive Program and the Prop 56 Value-Based Payment Program. The Alliance uses them to track and fulfill your Care-Based Incentives and Value-Based payments.
CPT II Category Codes always consists of…
CPT current procedural terminology II codes were developed by the American Medical Association (AMA) as a supplemental performance tracking set of procedural codes in addition to the Category I and III coding sets.
Category II codes are optional, and cannot be used to replace Category I codes for billing purposes.
La Alianza highly encourages clinical office and billing staff to use CPT Category II codes for performance measurement in order to decrease the need for provider data submission, record abstraction and chart review - your payments, faster!