Medicaid Reimbursement for Healthy Start Screening

1. Medicaid Reimbursement for Healthy Start Screening Florida Statute 383.14 requires that all pregnant women are offered the Healthy Start Prenatal Risk Screen by the prenatal care provider during the initial prenatal visit. The purpose of the prenatal risk screen is to identify pregnant women who may have risk factors that may affect their pregnancy, health or baby. The following slides will review Medicaid Reimbursement codes and guidelines for providers when filing to receive reimbursement for recipient�s who participate in Healthy Start prenatal risk screening. Note: County Health Departments can not bill Medicaid for the HS prenatal risk screen because CHDs are under a cost-based reimbursement with Medicaid, which includes completion of a consented Healthy Start prenatal risk screen as a component. It is only those health care providers who are on a fee for service reimbursement with Medicaid who can be reimbursed for the Healthy Start Prenatal Risk Screen.Florida Statute 383.14 requires that all pregnant women are offered the Healthy Start Prenatal Risk Screen by the prenatal care provider during the initial prenatal visit. The purpose of the prenatal risk screen is to identify pregnant women who may have risk factors that may affect their pregnancy, health or baby. The following slides will review Medicaid Reimbursement codes and guidelines for providers when filing to receive reimbursement for recipient�s who participate in Healthy Start prenatal risk screening. Note: County Health Departments can not bill Medicaid for the HS prenatal risk screen because CHDs are under a cost-based reimbursement with Medicaid, which includes completion of a consented Healthy Start prenatal risk screen as a component. It is only those health care providers who are on a fee for service reimbursement with Medicaid who can be reimbursed for the Healthy Start Prenatal Risk Screen.

2. Medicaid Reimbursement Code H1000: This code is used for services provided during antepartum (prenatal) visits, without completion of a Healthy Start Prenatal Risk Screen Reimbursement Rate $52.00 (age 21 and above) $54.08 (age 20 and below)