[Ohioaap-practicemanagers] Updates on codes 99420 (maternal depression) & 96127 (brief emotional/behavioral)

[Melanie Farkas]

I wanted to share this news with our practice manager network!

The Ohio Chapter, American Academy of Pediatrics (Ohio AAP) is excited to share that two important CPT codes will be covered by Medicaid and Medicaid Managed Care Organizations beginning January 1, 2016 at 80% of Medicare.

Leaders with the Ohio AAP have been working with Medicaid Director John McCarthy and his team for the last few months to add these codes to the Medicaid Fee Schedule. We appreciate Director McCarthy’s efforts on this and other issues that are important to Ohio’s pediatric community.

Code 99420 is defined as administration and interpretation of health risk assessment instrument. This code may be used to screen the mother for depression and can be billed under the baby’s name. This code can be billed multiple times as needed. Maternal postpartum depression can have serious adverse effects on the mother and child relationship and Bright Futures and the AAP Mental Health Task force recommend screening.

Ohio is just the sixth state in the nation to cover maternal depression screenings at pediatric preventative care visits through Medicaid. The other states are Colorado, Illinois, Minnesota, North Dakota and Virginia.

Code 96127 is defined as brief emotional/behavioral assessment (e.g. depression inventory, attention-deficit/hyperactivity disorder scale). Medicaid had told the Ohio AAP earlier this year that screenings including the Vanderbilt Questionnaires for ADHD and depression screenings should be billed under code 96110 (developmental screen). This created concern for our members since these screenings were different from developmental screenings.

Medicaid will now reimburse for code 96127 beginning January 1, 2016.

If you have questions about these codes, contact Melissa Wervey Arnold.



Melanie J. Farkas

Director of Communications & Immunization Programs

Ohio Chapter

American Academy of Pediatrics

Three-time recipient of AAP Outstanding Very Large Chapter Award (2006, 2010, 2014)

94-A Northwoods Blvd. | Columbus, OH 43235

614-846-6258 | fax 614-846-4025

OhioAAP.org<applewebdata://1EDBFD0C-8AFB-43BD-906E-CB252AAAF00B/ohioaap.org>


-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://lists.deltaforce.net/pipermail/ohioaap-practicemanagers/attachments/20151217/cfb4744f/attachment-0001.html>