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ALLIANCE ONLY – EVERY CHILD, EVERY YEAR Pediatric Well Visit Schedule. For Medi-Cal use PM 160 For Healthy Families and Healthy Kids use CMS 1500. Under 1 month. 1 - 2 months. 4 months. 6 months. 9 months. 12 months. 15 months. 18 months.
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ALLIANCE ONLY – EVERY CHILD, EVERY YEAR Pediatric Well Visit Schedule • For Medi-Cal use PM 160 • For Healthy Families and Healthy Kids • use CMS 1500 Under 1 month 1 - 2 months 4 months 6 months 9 months 12 months 15 months 18 months Yearly Well Visit for ages 2-21 years Schedule appointments to approximate the intervals noted above. Intervals do not need to be exact. Unlike the state-run CHDP program, the Alliance will pay fee-for-service for one Well-Care Exam each calendar year ages 2 to 21. Well Visit Required Components • Use above schedule (based on American Academy of Pediatrics recommendations) for all Alliance members. • The Alliance covers yearly Well Visits from 2nd to 21st birthday. • 1. Health and Developmental Assessment • 2. Full Physical Exam, Dental Screening/Referral • 3. Anticipatory Guidance, Health & Safety Education
