Date: January 23, 2017
To: Enrolled Physical, Occupational and Speech Therapists; Physicians; Advanced Practice Nurses; Local Health Departments; Home Health Agencies; and Hospitals
Re: Changes to Current Procedural Terminology (CPT) Codes Used for Separate Reimbursement of Risk Assessments
The purpose of this Informational Notice is to provide guidance regarding Current Procedural Terminology (CPT) coding changes for risk assessments reimbursed separately by Healthcare and Family Services (HFS). These CPT coding changes are effective with dates of service on or after January 1, 2017.
· Maternal (Perinatal) Depression –
· Postpartum: Use CPT code 96127 with HD modifier (96127 + HD) for postpartum depression screening conducted using an HFS approved tool. Can be conducted up to one year after birth; may be billed on the infant’s recipient number, if infant is the patient.
· Prenatal: Continue using code H1000 for prenatal risk assessment.
· Preconception Risk Assessment –
· Use CPT code 96160 for the Preconception Risk Assessment & Clinical Guidance Tool (Form HFS 27) developed by HFS.
· Risk Assessment –
· Use CPT code 96127 for HFS approved tools.
· Adolescent Alcohol and Substance Use and Abuse –
· Use CPT code 96127 for HFS approved tools.
· Objective Developmental Screening –
· Use 96110 for objective developmental screenings conducted using an HFS approved tool.
· Use 96111 for developmental assessments conducted using an HFS approved tool.
HFS approved screening and risk assessment tools are listed in the appendices to the Handbook for Providers of Healthy Kids Services.
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 1-877-782-5565.
Felicia F. Norwood
Director
