California
Comprehensive Perinatal Services.
22 CCR 51504
Source text
15 segments
22 CCR 51504
22 CCR 51504
§ 51504. Comprehensive Perinatal Services. Procedure Code Maximum Allowance Z6500 Initial comprehensive nutrition, psychosocial, and health education assessments and development of care plan, first 30 minutes each assessment (total of 90 minutes), including ongoing coordination of care. $135.83 Z6200 Initial nutrition assessment and development of care plan, first 30 minutes $16.83 Z6202 Initial nutrition assessment and development of care plan, each subsequent 15 minutes (Maximum of 1 ½ hours) Z6204 Follow-up antepartum nutrition assessment, treatment and/or intervention, individual, each 15 minutes (Maximum of 2 hours) Z6206 Follow-up antepartum, nutrition assessment, treatment, and/or intervention, group, per patient, each 15 minutes (Maximum of 3 hours) Z6208 Postpartum nutrition assessment, treatment, and/or intervention, including development of care plan, individual, each 15 minutes (Maximum of 1 hour) Z6210 Prenatal vitamin-mineral supplement, 300-day supply Procedure Code Maximum Allowance Z6300 Initial psychosocial assessment and development of care plan, first 30 minutes $16.83 Z6302 Initial psychosocial assessment and development of care plan, each subsequent 15 minutes (Maximum of 1 ½ hours) Z6304 Follow-up antepartum psychosocial assessment, treatment and/or intervention, individual, each 15 minutes (Maximum of 3 hours) Z6306 Follow-up antepartum psychosocial assessment, treatment and/or intervention, group, per patient, each 15 minutes (Maximum of 4 hours) Z6308 Postpartum psychosocial assessment, treatment, and/or intervention, including development of care plan, individual, each 15 minutes (Maximum of 1 ½ hours) Z6400 Client orientation, each 15 minutes (Maximum of 2 hours) Z6402 Initial health education assessment and development of care plan, first 30 minutes Z6404 Initial health education assessment and development of care plan, each subsequent 15 minutes (Maximum of 2 hours) Z6406 Follow-up antepartum health education assessment, treatment, and/or intervention, individual, each 15 minutes (Maximum of 2 hours) Z6408 Follow-up antepartum health education assessment, treatment, and/or intervention, group, per patient, each 15 minutes (Maximum of 2 hours) Z6410 Perinatal education, individual, each 15 minutes (Maximum of 4 hours) Z6412 Perinatal education, group, per patient, each 15 minutes (Maximum of 18 hours) Z6414 Post partum health education assessment, treatment, and/or intervention, including development of care plan, individual, each 15 minutes (Maximum of 1 hour)
(a)
Except where a capitated health system contract entered into by the Department provides otherwise, reimbursement for comprehensive perinatal obstetric, nutrition, psychosocial, and health education services shall be made only to comprehensive perinatal providers defined in Section 51179.1.
(b)
Except where a capitated health system contract entered into by the Department provides otherwise, reimbursement for comprehensive perinatal obstetric services shall not exceed the maximum allowances for similar services established in Sections 51503, 51509 or 51509.1, whichever is applicable, plus the following amounts.
(1)
An additional $50.00 shall be allowed for the initial comprehensive medical office visit when provided within 16 weeks of the last menstrual period.
(2)
An additional $100.00 in total shall be allowed for the tenth and all subsequent prenatal office visits.
(c)
Except where a capitated health system contract entered into by the Department provides otherwise, reimbursement for pathology services shall not exceed the maximum allowances established in Section 51529.
(d)
Except where a capitated health system contract entered into by the Department provides otherwise, reimbursement for comprehensive perinatal nutrition, psychosocial, and health education services shall not exceed the maximum allowances listed in this section. Reimbursement shall be claimed only for time spent rendering covered patient care services while in direct personal contact with the patient. Reimbursement shall not be claimed for similar services provided under the Maternal and Child Health program.
(e)
Reimbursement for the combined perinatal assessment procedure listed in subsection (1) shall be allowed only when all three indicated assessments and the initial comprehensive medical examination have been performed.
(1)
Maximum allowances for comprehensive perinatal nutrition, psychosocial, and health education assessment:
39.
96
(3)
Maximum allowances for comprehensive perinatal psychosocial services:
(4)
Maximum allowances for comprehensive perinatal health education services:
16.
83
2.
81
8.
41
Source outline
14 anchors in this source
