Provider Alerts

Purpose
This is a reminder to complete and correctly code standardized developmental screening for every eligible child by their first, second, and third birthdays.

Developmental Screening in the First Three Years of Life (DEV) is part of DHCS’s Managed Care Accountability Set (MCAS) and is reviewed annually by Health Services Advisory Group (HSAG), DHCS’s External Quality Review Organization (EQRO). Screening timing and content should also follow the American Academy of Pediatrics (AAP) Bright Futures periodicity schedule.

Important: Standardized developmental screening is a required component of a complete well-child visit under EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) – it is not optional or separate from the exam. A well-child visit that does not include a timely, standardized developmental screening at the appropriate periodicity interval is considered an incomplete EPSDT/wellness visit, regardless of whether all other exam components were completed. Providers should ensure DEV screening is built into visit workflows so that no well-child visit closes out without it.

Eligible Population and Indicators

• Members age 1–3, assessed across three separate age-specific indicators: screening completed in the 12 months preceding or on the child’s first birthday, second birthday, and third birthday.
• Each birthday indicator is scored independently — a child can be compliant for one birthday and not another depending on whether a qualifying screening occurred in that specific window.

AAP Bright Futures Periodicity and Screening Content

• Bright Futures recommends standardized developmental screening at the 9-month, 18-month, and 30-month well-child visits, aligning naturally with the three DEV birthday indicators.
• The standardized tool used must assess all of the following domains: motor (fine and gross), language, cognitive, and social-emotional development.
• Bright Futures also recommends autism-specific screening (e.g., M-CHAT-R/F) at the 18-month and 24-month visits — this is a complementary recommendation and separate from the general developmental screening tools used for DEV, but both fit naturally into the same visit schedule.

Acceptable Standardized Tools

• Ages and Stages Questionnaire, 3rd Edition (ASQ-3), and ASQ: Social-Emotional (ASQ:SE).
• Parents’ Evaluation of Developmental Status (PEDS) and PEDS-Developmental Milestones (PEDS-DM).
• Survey of Well-being of Young Children (SWYC).

A full list of AAP approved screening tools can be found here: https://aap2.silverchair-cdn.com/aap2/content_public/journal/pediatrics/145/1/10.1542_peds.2019-3449/7/peds_20193449supplementarydata.pdf

What We’re Asking Providers To Do

• Administer a standardized developmental screening tool at the 9-, 18-, and 30-month well-child visits (or otherwise within 12 months preceding each birthday), covering all four required domains.
• Bill CPT code 96110 every time a standardized screening is completed, regardless of capitation status or FQHC billing arrangement — this is the only way the service is reflected in the measure.
• Document in the chart which tool was used, the date of screening, and evidence the tool was completed and scored.
• For any concerns identified through screening or developmental surveillance, document the follow-up plan (referral to early intervention (Local Regional Center’s Early Start Program), specialty care, or repeat screening) clearly for medical necessity.

Documentation & Coding Tips

You can find the full Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP (Child Core Set) Technical Specifications and Resource Manual for 2026 Reporting here: https://www.medicaid.gov/medicaid/quality-of-care/downloads/medicaid-and-chip-child-core-set-manual.pdf?t=1787244610

Historical information about the Developmental Screening requirement can be found in the DHCS APL 23-016. https://www.dhcs.ca.gov/wp-content/uploads/2025/10/APL23-016.pdf

For additional best practices and coding for this measure and others refer to the MY2026 Provider Pocket Guide – for a copy of the guide reach out to your provider services representative at 1-888-936-PLAN (7526).

If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org