Prop 56 Childhood Development Screening & Provider Survey
| Date: | November 24, 2021 |
| To: | All HPSJ PCPs, Providers, and Family Pediatricians |
| Provider Alert Type: | Regulatory |
| From: | Health Plan of San Joaquin |
| Subject: | Prop 56 Childhood Development Screening & Provider Survey |
| Business: | Medi-Cal |
Reminder: In December of 2019, the Department of Health Care Services (DHCS) added additional reimbursement for developmental screening for dates of service from January 1, 2020, through December 31, 2021. Health Plan of San Joaquin (HPSJ) will reimburse providers for developmental screenings with funds from the California Healthcare, Research and Prevention Tobacco Tax Act of 2016 (Proposition 56). The Fiscal Year 2019 – 2020 Governor’s budget included funds to be allocated for payments to support developmental screenings for children enrolled in full-scope Medi-Cal coverage under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. More information can also be viewed in this Fall 2021 issue of PLANSCAN.
Prop 56 Childhood Development Screening Policy
- Effective Date: January 1, 2020
- Target Population: Children up to age 30 months (excludes those dually eligible for Medicare and Medi-Cal)
- Provider Types: All
- CPT Code: 96110 (without modifier KX)
- Rate: $59.90*
*Value Based Payment reimbursement rate, this is in addition to HPSJ’s Provider Incentive Program rate.
Survey Request: To understand the use and efficacy of the Childhood Developmental screening tools, HPSJ is inviting our provider network to participate in a survey at
http://www.hpsj.com/form-view/54, on our provider portal.
If you have questions, please contact our Quality Management Department at quality@hpsj.com.