Billing

Developmental screening can be billed using CPT billing code 96110 or ICD-10 Z13.4. This covers the time a physician scores, reviews results, and interprets findings.  Billing for developmental screening using these codes requires documentation that the screening was given and notes any action taken, such as follow-up screening, developmental milestone information, or referral to community agency or community resource. Reimbursement rates vary by insurance provider. Contact insurance providers directly to learn the reimbursement rate.  For Behavioral/Social Emotional screening of young children use CPT code 96127. For Maternal Depression use CPT Code 96161.

 

Downloadable Materials

  1. Birth to 5: Watch Me Thrive Developmental Screening Passport 
  2. Sample Workflow from Help Me Grow Ventura County
  3. Sample of a Behavioral Health Referral Mechanism – from Alameda County
  4. Developmental Screening Landscape Analysis – California Statewide Screening Colloaborative

 

Citations

Citations downloadable PDF

 

Federal & National Initiatives

Birth to Five: Watch Me Thrive!: https://www.acf.hhs.gov/ecd/child-health-development/watch-me-thrive

CDC Learn the Signs. Act Early: https://www.cdc.gov/ncbddd/actearly/

AAP Bright Futures: https://brightfutures.aap.org/Pages/default.aspx

 

California State Programs

California Early Start (Part C): http://www.dds.ca.gov/earlystart/index.cfm

Child Health and Disability Prevention (CHDP): http://www.dhcs.ca.gov/services/chdp/Pages/default.aspx

Help Me Grow California Program: http://helpmegrowca.org/

High Risk Infant Follow Up (HRIF): http://www.dhcs.ca.gov/services/ccs/Pages/HRIF.aspx

MCAH Programs: http://www.cdph.ca.gov/programs/MCAH/Pages/MCAHDirectorsandLocalTollFreeNumbers.aspx

 

Resources for Families

Early Start Website Directory: http://www.dds.ca.gov/EarlyStart/docs/central_directory.pdf

Family Resource Center Network of California: http://www.frcnca.org/

Early Start Neighborhood: http://earlystartneighborhood.ning.com

California Early Intervention Technical Assistance Network: http://www.ceitan-earlystart.org/

 

Health Care Insurance Information

Patient Protection and Affordable Care Act (PPACA): https://www.hhs.gov/healthcare/about-the-law/preventive-care/index.html

Medi-Cal: http://www.medi-cal.ca.gov/

 

Recent Publications

February 2018. Early Identification and Intervention Systems in California: Bright Spots and Lessons Learned