Well-child Encounters in the Era of COVID-19

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Although non-urgent face-to-face visits are largely suspended, families need our help more than ever. Below is information on how to care for children remotely, advise parents, measure developmental-behavioral progress and receive payment for care.

Reaching Families

HIPAA has suspended security requirements for telemedicine, so clinicians can use FaceTime or Skype for telemedicine for the time-being. This means you can phone or video call. Append the modifier "- 95" to a regular visit code. Most families have cellphones and most often smart-phones. Android users must download Skype. For iPhone users Facetime works (as does Skype which is available in the Apple App Store).

Telephone/tele-video calls to families are reimbursable: Use 99358: Prolonged services without direct patient contact; 30 – 60 minutes [$113.41] and +99359 for each additional 30 min. [$54.55]

For more information see: AAP care coordination coding fact sheet.pdf

Measuring Development-Behavior/Mental Health

For advice to be effective, evidence-based triaging is essential. Triage identifies specific topics for developmental-behavioral promotion and anticipatory guidance, thus creating “teachable moments.”

  • Several quality developmental-behavioral screening tools are available online via parent portals. Parents do not see results.
    The following are on all State lists and approved by the AAP:
  • The above measures are eligible for 96110 reimbursement while informal milestones built into EHRs are not. Append to the well-visit code a modifier, usually – 25 or – 59 (per payer requirements).
  • Next list 96110 and the number of screens administered. For example if using all three screens within PEDS Online, write 96110 (X 3). Payment is, on average, $8.00 per screen although some States have different reimbursement schemes.
  • If conducting a parent depression screen (such as the PSQ-9 or Edinburgh) use 96161.

Billing and Coding for Care Coordination

  • If a patient is found to have two or more long-term problems, use the Chronic Care Management code: CPT 99490 - for at least 20 minutes of assisting families with referrals to early intervention services including Head Start, IDEA programs, etc.
  • For more information on care coordination codes see the AAP’s Medical Home website: Coding and Billing for Care Coordination

Finding Parenting Information Resources

  • For sharing advice on Covid-19 in multiple languages, see Coronavirus
  • For developmental-behavioral promotion handouts for parents - or for sending families links to reputable websites see: Parenting Information Resources
Frances Page Glascoe, PhD
Professor of Pediatrics
FAAP (Hon)
info@pedstest.com

Disclosure: Dr. Glascoe is the author of one of the online early detection resources mentioned in this article but supports quality measures by other publishers.