Posted Sep 29, 2025
Effective December 24, 2025, the U.S. Preventive Services Task Force (USPSTF) reaffirmed its Grade B recommendation for the screening of women of reproductive age—including those who are pregnant and postpartum—for Intimate Partner Violence (IPV).
A printable PDF is available here.
This preventive care recommendation aligns with prior 2018 guidance and underscores the importance of early identification and intervention
This guidance applies to Qualified Health Plans (QHPs) and all Essential Plan (EP) variants under the preventive service requirements.
Definition: IPV includes physical violence, sexual violence, psychological aggression (such as coercive tactics limiting access to financial resources), and stalking by a current or former spouse or intimate partner.
| Question | Answer |
|---|---|
| Who should be screened? | Adolescent and adult women of reproductive age, including those who are pregnant or postpartum, regardless of whether they exhibit signs or symptoms of IPV. |
| How Should Screening Be Conducted? | Use a brief, validated questionnaires designed to assess current or recent abuse. |
| What if a Patient Screens Positive? | Evaluate and, if appropriate, provide or refer the patient to evidence-based interventions that include: |
Under New York State Insurance Law, USPSTF Grade 'A' and 'B' preventive services—such as IPV screening—must be covered without cost-sharing.
For accurate claims submission, refer to the approved CPT and diagnosis codes listed below. These codes reflect preventive services consistent with the USPSTF recommendation.
The approved diagnosis code is Z13.89 – Encounter for screening for other disorder.
| CPT Code | Description |
|---|---|
| 99384 | Initial comprehensive preventive medicine evaluation and management (E/M) of a new adolescent (age 12–17) patient |
| 99385 | Initial comprehensive preventive medicine E/M of a new adult (age 18–39) patient |
| 99386 | Initial comprehensive preventive medicine E/M of a new adult (age 40–64) patient |
| 99387 | Initial comprehensive preventive medicine E/M of a new senior (age 65+) patient |
| 99394 | Periodic comprehensive preventive medicine E/M of an established adolescent (age 12–17) patient |
| 99395 | Periodic comprehensive preventive medicine E/M of an established adult (age 18–39) patient |
| 99396 | Periodic comprehensive preventive medicine E/M of an established adult (age 40–64) patient |
| 99397 | Periodic comprehensive preventive medicine E/M of an established senior (age 65+) patient |
| 99401 | Preventive counseling and/or risk factor reduction intervention(s); approximately 15 minutes |
| 99402 | Preventive counseling and/or risk factor reduction intervention(s); approximately 30 minutes |
| 99403 | Preventive counseling and/or risk factor reduction intervention(s); approximately 45 minutes |
| 99404 | Preventive counseling and/or risk factor reduction intervention(s); approximately 60 minutes |
| 99411 | Preventive group counseling/risk reduction intervention(s); approximately 30 minutes |
| 99412 | Preventive group counseling/risk reduction intervention(s); approximately 60 minutes |
If you have any questions, please contact your Network Account Manager, or call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am-5:30pm.
Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”).
R25-48
October 2025
