Update on Pregnancy Medical Home Claims

All Pregnancy Medical Home claims need to include the modifier “AF� with the procedure code submitted, regardless of the dates of service. The "AF" modifier will enable the provider to be paid at the rate previously received in the legacy system. The NCTracks system supports all three types of Pregnancy Medical Home claims that receive higher reimbursement, including the pregnancy risk screening, delivery, and post partum plan.

Providers who previously filed Pregnancy Medical Home claims that were denied or pended for Edit 353 (rate not found) need to re-submit the claims using the "AF" modifier.