skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. Information for Medicare beneficiaries is only available on the medicare.gov website.
En Español
Text Size:
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]
Last Modified: 12/13/2017 Location: FL, PR, USVI Business: Part A, Part B

HETS application: IPPE HCPCS code changes and preventive HCPCS code financial changes

The Centers for Medicare & Medicaid Services (CMS) released several changes to the Health Insurance Portability and Accountability Act (HIPAA) Eligibility Transaction System (HETS), which went into effect November 4, 2017. The changes impact providers who use First Coast Service Options’ (First Coast’s) Secure Provider Online Tool (SPOT) to access eligibility data through HETS.

IPPE HCPCS Code Changes

HETS 271 response may return Initial Preventive Physical Examination (IPPE) preventive HCPCS code information differently. The IPPE HCPCS codes (G0402, G0403, G0404, and G0405) are returned by HETS as supported preventive codes, with their next eligible dates set to the first day of the beneficiary’s initial Part B enrollment by CWF. IPPE services are only available within the Medicare beneficiary’s first 12 months of Medicare Part B eligibility.

Preventive HCPCS Code Financial Changes

HETS no longer returns preventive HCPCS code financial information for QMB periods when the beneficiary is dual-eligible for both Medicare and Medicaid for the entire year.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.