Healthier Generation Benefit

Healthier Generation Benefit

A benefit to children and families for the prevention, assessment and treatment of childhood obesity.

Introduction to the Healthier Generation Benefit

In August 2013, Blue Cross and Blue Shield of Kansas City (Blue KC) joined the American Academy of Pediatrics and the American Academy of Dietetics to collaborate with the Alliance for a Healthier Generation, to offer a benefit to children and families for the prevention, assessment and treatment of childhood obesity. The information below explains the benefit, eligible employer groups and reimbursement. Should you have any questions about the benefit or are interested in getting more information, please contact your Provider Relations Representative.

What is the Healthier Generation Benefit?

The Healthier Generation Benefit (HGB) is a three-year pilot program and promises to yield critical findings regarding what clinical steps are effective in preventing and treating childhood obesity.

Eligibility & Coverage

Please refer to the eligibility and coverage link below for details on eligible employer groups. We are offering insurance coverage to eligible children for four (4) visits with their primary care provider and four (4) visits with a Registered Dietitian (RD) per year. A list of recommended RDs is below. The benefit will process with no copayments for these members through an in-network provider.

Expanded CPT Codes:

The HGB has expanded the range of codes used. Beginning January 2014, program visits should be coded with ICD-9 code range 278 – 278.03 in the primary position and CPT code range 99205 – 99215. Use V85.53 to record BMI of 85% to <95% or V85.54 to record BMI > 95% in the secondary diagnosis field.

Thank you for your continued participation in the Blue KC networks.

Helpful Links

Who is Eligible?

To be eligible for the pilot program children must be covered by Blue KC and meet the following criteria:

  • Between the ages of 3 and 18
  • At or above the 85% BMI for age
  • No co-morbidity condition required
  • In one of the employer groups listed below

Eligible Employer Groups

Effective: August 1, 2013 – August 1, 2016
Group Name ID Number
Blue Cross and Blue Shield of Kansas City – Group 25 10025000
Board of Police Commission 10825000
Johnson County Community College 14092000
Kansas City Missouri School District 11828000
Effective: January 1, 2014 – January 1, 2017
Group Name ID Number
Blue Valley Unified 14274000
Clay County 31517000
Garmin International / Garmin 11406000
Jackson County Missouri 31618000
Lee's Summit RVII School District 23671000
Metropolitan Community College 32129000
Olathe Health Systems Inc. 3159600
Olathe School District 11640000
Shawnee Mission USD 512 11455000
Unified School District #500 32076000
University of Kansas Hospital Authority 16379000
Effective: May 1, 2014 – May 1, 2017
Group Name ID Number
City of Kansas City Missouri Health Care 24166000

Reimbursement

The HGB has expanded the range of codes used. Beginning January 2014, program visits should be coded with ICD-9 code range 278 – 278.03 in the primary position and CPT code range 99205 – 99215. Use V85.53 to record BMI of 85% to <95% or V85.54 to record BMI > 95% in the secondary diagnosis field.

Claims for Registered Dietitians will be coded with ICD-9 code range 278 – 278.03 in the primary position and CPT code range 97802 – 97804. Use V85.53 to record BMI 85% to < 95% or V85.54 to record BMI > 95% in the secondary diagnosis field.