Practice Management

MEIPASS (Medicaid EHR Incentive Program) is now open for meaningful use (MU) attestations.  Please note that the MU attestation is hybrid as it is comprised of two parts.

  1. Attest in MEIPASS
  2. Complete the Meaningful Use Workbook

The deadline for 2015 MU is 6/30/2017.
The deadline for 2016 MU is 9/15/2017.

Visit MEIPASS to begin your MU attestation.


As documented in the August 2016 issue of Medicaid Update, Medicaid FFS would pay for maternal depression screening in the infant’s chart and Medicaid Managed Care would cover the service as of November 2016.  The guidance can be found here: https://www.health.ny.gov/health_care/medicaid/program/update/2016/aug16_mu.pdf and is reproduced below:

Postpartum Maternal Depression Screening Updated Billing Guidance: This article supersedes the billing guidance for postpartum maternal depression screening that was published in the July 2015 Medicaid Update. Effective September 1, 2016 for Medicaid Fee-for-Service (FFS) and effective November 1, 2016 for Medicaid Managed Care (MMC) Plans, the New York State Medicaid program will allow providers of infant healthcare to bill for postpartum maternal depression screening under the infant’s Medicaid identification number. Also, the current CPT code used for maternal depression screening (99420) will be replaced with the following:

• G8431 (with HD modifier) – Screening for clinical depression is documented as being positive and a follow-up plan is documented • G8510 (with HD modifier) – Screening for clinical depression is documented as negative, a follow-up plan is not required

Postpartum maternal depression screening using a validated screening tool may be reimbursed up to three times within the first year of the infant’s life.  This reimbursement is in addition to the payment for an Evaluation and Management (E&M) service.  Screening can be provided by the mother’s healthcare provider and/or by the infant’s healthcare provider following the birth of the baby.  This service can be integrated into the well-child care schedule.  If the mother screens positive for depression, then she must be further evaluated for diagnosis and treatment.  Medical practices that do not have the capacity to evaluate and treat mothers who screen positive for depression must have a referral process in place for these beneficiaries.  Women with current depression or a history of major depression warrant particularly close monitoring and evaluation.  The current standard of care for pregnant women requires that all pregnant women receive depression screening as part of their routine antepartum care.  Maternal depression screening that occurs antepartum is considered to be included in the payment for the E&M service.  A maternal healthcare provider is defined as a: physician, midwife, nurse practitioner, physician assistant, or other healthcare practitioner acting within his or her lawful scope of practice.  The infant’s healthcare provider is defined as a: physician, nurse practitioner, physician assistant, or other healthcare practitioner acting within his or her lawful scope of practice.

I hope that this information is of value to you in your practice. Implementing maternal depression screening is not difficult and helps insure the health of the mother-infant dyad.  If you have further questions about this coding issue or others please email me.  Please note that many private payers are not currently paying for maternal depression screening, and it is one of our priorities to advocate for this and all the other services recommended in Bright Futures.  Our recommendation is to bill all insurers for the service when provided even if they do not currently pay.  The realization by insurers that this is a valuable service may take some time.


AAP Private Payer Advocacy Article:  AAP New York Chapter 2 Pediatric Council Successful in Advocacy on Vaccine Payment

As reported by Steve Goldstein, MD, FAAP, the New York Chapter 2 pediatric council had several contacts with CareConnect concerning underpayment for vaccines.  After sharing the AAP Business Case for Pricing Vaccines and the Business Case for Pricing Immunization Administration, CareConnect committed to follow the AAP payment guidelines and promised to go back to reconsider most of the vaccine visits they underpaid.  The new vaccine payment schedule will go into effect on January 1, 2017.


Below are a number of links that will help in the management of your Pediatric practice:

Billing:

Coding:

Other:


The National Center for Medical Home Implementation (NCMHI) in the American Academy of Pediatrics (AAP) is pleased to announce the launch of its new and improved Web site, www.medicalhomeinfo.org.

The Web site provides pediatric medical home information, tools, and resources for practices and clinicians, specifically pediatricians. Visit the Web site to learn about the following:

  • Education and training opportunities
  • Tools and resources for pediatric medical home implementation
  • Evidence supporting the pediatric medical home model
  • Information about pediatric medical home initiatives in 50 states and the District of Columbia