Use standardized screening tools at appropriate ages to receive incentive for Texas Health Steps checkups

posted 07.07.11

The American Academy of Pediatrics states that early identification of developmental disorders is critical to the well-being of children and their families. Developmental screening is an integral function of the primary care medical home and an appropriate responsibility of all pediatric health care professionals.

In September 2009, Texas Health Steps providers began receiving additional reimbursement for THSteps medical checkups when using the following standardized screening tools:

• Ages and Stages Questionnaire (ASQ),
• Ages and Stages Questionnaire: Social Emotional (ASQ:SE),
• Parents Evaluation of Developmental Status (PEDS), and
• The Modified Checklist for Autism in Toddlers (M-CHAT).

Effective Sept. 1, 2011, these tools must be used at the ages specified in the table below for a THSteps medical checkup to be considered complete. The additional reimbursement for use of these specific tools will continue to be available. THSteps originally notified providers of this requirement in 2009 when the policy allowing the additional reimbursement became effective.

The Preventive Care Medical Checkup policy implemented Sept. 1, 2009, outlined these specific recommended ages and tools:

Providers may submit CPT code 96110 for reimbursement for use of these tools. Modifier U6 must be used for autism screening.

AAP, the American Academy of Neurology, the Child Neurology Society, and other organizations rate the ASQ and PEDS as high-quality developmental screening tools. The ASQ, PEDS and M-CHAT all fulfill AAN criteria related to national standardization, reliability, validation against criterion diagnostic tests, and accuracy.

More details on these tools and information on integrating the tools into the physician’s practice can be found in the THSteps Online Provider Education module “Using Developmental Screening Tools” at www.txhealthsteps.com. In addition, a “Screening Implementation Worksheet” with practice set-up information is available at Developmental Behavioral Pediatrics Online, www.DbPeds.org. Applying the AAP’s “Developmental Surveillance and Screening Algorithm with a Pediatric Preventive Care Visit” can also help integrate developmental surveillance and screening into practice settings.

For additional information on the THSteps policy, please contact Mindy Schroeder, BSN, RN, nurse consultant, THSteps, Department of State Health Services, at (512) 458-7111, ext. 2102, or by e-mail at mindy.schroeder@dshs.state.tx.us.