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Health Center

Student Guide to Health Program Requirements

The SXU Health Center not only serves are own students, but students all over the Chicagoland area in completing their health program requirements. A common question that we get is about insurance and cost. This guide is meant to clarify some of these questions.

Cost and Insurance Reimbursement FAQs

What is required?

Different programs may have different requirements, but many include some or all of the following:

Physical Exam
Annual influenza vaccine
Tdap (tetanus/diptheria/pertussis) vaccine in the last 10 years
Tuberculosis screening (either a PPD skin test or blood test)
Titers: A blood test to check for immunity to certain diseases. Most programs check for immunity to measles, mumps, rubella, varicella, and hepatitis B.
Urine Drug screen (10-panel)
Immunizations: If your titers show that you are not immune to measles, mumps, rubella, varicella, and/or hepatitis B you may be required by your program to have additional vaccine boosters. These vaccine boosters for health programs are usually: MMR, Hepatitis B, and Varicella. Most programs also require a Tdap vaccine in the last 10 years.

Will my insurance pay for it?

Some insurance plans will cover all of these services. Some will cover none because they consider it a school-related expense and not medically necessary. It all depends on your individual plan.

It is your responsibility to call the number on the back of your insurance card to find out if you have coverage for these services. When you call your insurance carrier, you must give them the specific CPT code unique to that service to verify coverage. If you do not provide them with these CPT codes, you may not get accurate information.

  • If you do have insurance coverage for these services, you will get the best coverage from going to an in-network provider. (The SXU Health Center is in-network with PPO's from Aetna, BC/BS, Humana, Medicare, and United Health Care. The lab that we use is Quest Laboratories).
  • Please note that even if these services are covered you may still get a bill if you have not met your yearly deductible yet. Every plan has different deductible amount. If this is the case, it is then in your best interest to find a location that charges a reasonable amount for these services.

What if my insurance won't pay for these services or I don't have insurance?

If you do not have insurance coverage for these services, you will want to find the best self-pay prices. The SXU Health Center keeps prices as low as possible in order to serve our student population. Please call 773-298-3712 to discuss pricing.

What are the CPT codes for common health program requirements?

Below are the CPT codes for the most common health program requirements. If you have any questions, would like to discuss our self-pay rates, or your program requires different services, please contact the SXU Health Center at 773-298-3712.

Service CPT Code Notes
Physical   CPT Code depends on age
Urine Drug Screen 80101 Self-pay only
Titers
Hepatitis B Titer (HBsAB) --Quantitative 86317  
Measles (Rubeola) Titer 86765  
Mumps Titer 86735  
Rubella Titer 86762  
Varicella Titer 86787  
Hepatitis B Surface Antigen 87340 This tests for active hepatitis B disease and is not required by many programs.
Tuberculosis Testing
PPD Skin Test 86580 The 2-step PPD requires the placement of (2) separate tests.
Quantiferon Gold 86480 A blood test that takes the place of a 2-step PPD. Some programs require this and some have no preference.
Immunizations
Influenza vaccine 90686 Given annually
Hepatitis B - (0-19 yrs) vaccine 90745 Series: 3 doses
Hepatitis B - (20 years +) vaccine 90746 Series 3: doses
MMR (measles, mumps, rubella) vaccine 90707 Series 2: doses
Tdap (tetanus/diphtheria/pertussis) vaccine 90715 1 dose every 10 years
Varicella (Chicken Pox) vaccine 90716 Series: 2 doses