Reimbursement policy update: Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

Policy Update

Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

(Policy 06-0149, effective 11/30/19)

 

Currently, HealthKeepers, Inc. includes Early and Periodic Screening, Diagnosis and Treatment (EPSDT) component services in the reimbursement of Anthem HealthKeepers Plus preventive medicine evaluation and management (E&M) visits unless they are appended with Modifier 25 to indicate a significant, separately identifiable E&M service by the same physician on the same date of service.

 

However, effective November 30, 2019, the following EPSDT component services will be separately reimbursable from preventive medicine E&M visits:

 

• Hearing screening with or without the use of an audiometer or other electronic device

 

• Vision screening

 

For additional information, please review the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) reimbursement policy at https://mediproviders.anthem.com/va.