Billing for EPSDT (Medicaid Patients Only)

Use these codes when reporting Early and Periodic Screening, Diagnosis and Treatment (EPSDT) "Normal Newborn" or "Well Child" exams of Medicaid patients.
Go to the www.mich.gov website for the EPSDT Guidelines.

Code(s)	Description
New Patient Visits
99431	History & physical of inpatient "Normal Newborn"
99435	History & physical of newborn for same day discharge
99381	Initial evaluation, under age of 1 year
99382	Initial evaluation, age 1-4 years
99383	Initial evaluation, age 5-11 years
99384	Initial evaluation, age 12-17 years
99385	Initial evaluation, age 18-21
Established Patient Visits
99391	Reevaluation, under age of 1 year
99392	Reevaluation, age 1-4 years
99393	Reevaluation, age 5-11 years
99394	Reevaluation, age 12-17 years
99395	Reevaluation, age 18-21 years
EPSDT-Required Services That May Be Billed Separately	When performed according to the periodicity table. For complete descriptions, refer to the Physician's Current Procedural Terminology code book.
85014	Hematocrit
85018	Hemoglobin
81002	Urine testing with standardized reagent dipstick for sugar & albumin
90700-90749	Immunizations Continue to obtain the serum from local health department
86580 or 86585	Tuberculin testing (TB)
90471	One vaccine
90472	Subsequent vaccines Must bill administration code and immunization code, even if immunization serum was free.
96110	Denver II test Remarks section must note "Denver II Test was performed for EPSDT"
99341	Blood lead educational visit using dx code 984.0-984.9 (go to table of drugs & chemical for specificity)