Posts

96110 Coverage During Well Visits

This blog is going to raise more questions than it answers, but one let’s get one of the few clear answers we have out of the way: pediatricians do not appear to follow Bright Futures’ periodicity schedule for developmental screening.  I realize that may not shock many of you, but you might be shocked to …

Amazing List of Screening Tools

I originally started this blog as an effort to publicly share resources and stories that I’ve gathered over the years and boy did I just land a doozy.  Thanks to Jan @ PCC, who dug up A Table of All Screening Tools and Rating Scales.  I presume – and encourage verification – that these are …

2012 96110 Update – Good News [Update]

It looks like your hard work paid off!  From a CMS bulletin dated 12/29/2011: This change resulted in many questions and potentially unintended consequences for other payers. We want to be clear that Medicaid and other private payers will be able to continue to use code 96110 even though it is a statutorily non-covered service …

96110 Emergency – Please Act!

The AAP has issued an important call to action for pediatricians, and those who work for them, relating to a proposed change to the 96110 CPT code, a subject about which I’ve written many times (these are just a fraction of the blog entries, you can see them all here). It appears that during the …

96110 Update, 1Q 2011

A request was made on SOAPM for a better understanding of the payment for developmental screening, namely the 96110 and 96111.  Here’s the update for 1Q 2011, where we examined tens of thousands of 9611X CPT codes used by our clients.  The average charge for the 96110 was $42.02 with a low of $10 and …

More 96110 Payment Details

OK, I think I have written about the 96110 more than any other specific subject! First, big thanks go out to Igor for getting this data for me. Sure, he deserves a raise…we all do. The list below should not be considered a 100% accurate report of which payers, by state, cover the 96110 (or …

Who Pays For What? Today: the 96110

I have had a number of off-line and on-line requests for details about who, exactly, is paying for the deveopmental testing (96110 and 96111) and non-face-to-face codes (or the “telephone codes”), so Igor was kind enough to look it up for me. As an aside, PCC allows our customers a great deal of flexibility when …

96110 Update

I’ve written extensively about 96110 usage among practicing pediatricians in the past and wanted to provide an update for 2008/9. 96110 Charge Reimbursement Data (Paid-off Charges, 2008/9) Average Charge Average Ins. Payment Average Pers. Payment Average Total Payment 2008 $40.26 $11.01 $1.41 $12.42 2009 $38.40 $12.50 $.98 $13.48 The declining personal charges combined with the …

96110 Developmental Test Data (Not Eagleville, CA)

This weekend, a very faithful reader wrote to me: Couple of things I wanted to mention. First, my two doctors said they LOVED the conference in Columbus. They said it was definitely worth it. As a result, it seems I have some work cut-out for me. They’ve come back energized and telling me “… we …

Final 96110 and More Personalized Medicine

I have some fascinating data about the after hours, etc., codes (9905x) coming, but I wanted to share these two followup tidbits before I forget: The Developmental Screening Toolkit For Primary Care Providers looks like an excellent site to add to the list I posted the other day. In particular, here’s a great comparison chart …