Medicaid well-child visits: Billing correctly for services rendered

Often, physicians complete the services of a Medicaid well-child visit (physical, developmental screening, anticipatory guidance, BMI percentile, and counseling for nutrition and physical activity) but aren't receiving credit because visits may not be billed correctly or are missed. Please be sure to document all components of the well-child visit at sick visits, sports physicals or new patient preventive services, and bill us using the correct CPT codes for billing available at priorityhealth.com.

Standards for frequency are 0-15 months (six visits), 3-6 years and 12-21 years (one visit/year).

Note: Maternal Infant Health Program and Women, Infants and Children (WIC) visits do NOT substitute for well-child visits with the primary care physician (PCP).

Topics: Preventive care