Billing

Screening for developmental delays like autism is important. Getting reimbursed for those screens is also important. 

Medicaid is able to reimburse for developmental screening through the 96110 code. Other reimbursement rates depend on the insurance provider, some of whom will not reimburse for developmental screening. If you come across insurance providers who will not reimburse for developmental screening, please e-mail Jonathan Price, Chair of the Ohio AAP Pediatric Care Council.

 

The American Academy of Pediatrics is working to improve reimbursement rates for these essential screens. You can help be part of the solution through the following links.

 

-American Academy of Pediatrics Developmental Surveillance and Screening Recommendations: How to Get it Done in Practice

 

-Template Letter: Appeal to Payers for Payment

 

-AAP Letter: AAP Notifies National Payers Regarding Developmental Screenings

 

-Chapter Pediatric Councils Report on Payment for Developmental Screening

 

-AAP Letter: Developmental Screening and Testing

 

-Developmental Screening/Testing Coding Fact Sheet for Primary Care Pediatricians

 

-AAP Private Payer Advocacy Update: October 2008- AAP activities for carrier coverage and payment for: Obesity, Mental health/Developmental screening and Medical home 

 

-AAP Private Payer Advocacy Update: August 2008-Cigna clarifies payment policy on developmental screening