Navigating Costs and Coverage with Iron Health

I’ve received an invite to Iron Health, what will it cost me?

A few key things to know:

  • Iron Health is an in-network provider. What does that mean? It means that the insurance your OB/GYN accepts is the same for Iron Health since we are an extension of their practice.
  • When searching your insurance portal or calling your insurance provider, use the name of your OB/GYN practice (Iron Health won't be listed separately).
  • Billing and payments for Iron Health will be processed via your OB/GYN’s practice.

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How to determine what Iron Health services will cost:

  • Look at your insurance card and determine if there are any copays associated with primary / specialty care. Copays are typically applied to a single visit and will be part of your bill from your OB/GYN’s practice.
  • If you have a deductible, it will apply to Iron Health services.
  • Understand your plan’s coverage of Iron Health services. Iron Health’s care results in certain billing codes (see next pages) that are processed the same way a visit to your OB/GYN would be processed. Please note - there are plan specific attributes (such as having a certain diagnosis as a prerequisite) that will impact coverage. It’s important to understand those nuances as it may impact coverage.

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How to put this into action:

  • Go on your online insurance portal and search for these codes using the name of your OB/GYN (not Iron Health).
  • Call your insurance company directly. They may want to know the provider in which case you can mention your OB/GYN.
Behavioral Health Care Manager Visits
CPT Code
Description
99492
Initial psychiatric collaborative care management, first 70 minutes in the first calendar month.
99493
Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month
99494
Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month
Advanced Practitioner Evaluation & Management Visits
(As part of Iron Health’s Primary Care / Weight Management / Menopause)
CPT Code
Description
99211
5-9 minute visit length OR very low complexity concern(s)
99212
10 - 19 minute visit length OR low complexity concern(s)
99213
20 - 29 minute visit length OR moderate complexity concern(s)
99214
30 - 39 minute visit length OR high complexity concern(s)
99215
40+ minute visit length OR very high complexity concern(s)
99453*
Remote patient monitoring; Initial patient set up and education on use of equipment
99454*
Remote patient monitoring; delivery of results/reports by practice staff to the provider caring for the patient
99457*
Remote patient monitoring; first 20 minutes of provider's interpretation and interactive communication with the patient/caregiver every month
99458*
Remote patient monitoring; subsequent 20 minutes of provider's interpretation and interactive communication with the patient/caregiver every month
Registered Dietician Visits
(As part of Iron Health’s Primary Care / Weight Management / Menopause)
CPT Code
Description
97802
Medical nutrition therapy; initial assessment and intervention, individual, face to face with the patient, each 15 minutes
97803
Medical nutrition therapy; re-assessment and intervention, individual, face to face with the patient, each 15 minutes
99453
Remote patient monitoring; Initial patient set up and education on use of equipment
99454*
Remote patient monitoring; delivery of results/reports by practice staff to the provider caring for the patient
99457*
Remote patient monitoring; first 20 minutes of provider's interpretation and interactive communication with the patient/caregiver every month
99458*
Remote patient monitoring; subsequent 20 minutes of provider's interpretation and interactive communication with the patient/caregiver every month
*Remote Patient Monitoring CPT codes can occur outside of a visit and are dependent on device utilization. 

I’ve received a bill. Now what?

Since billing and payment for Iron Health services is through your OB/GYN provider, please reach out to the practice directly with any questions or concerns.