Reimbursement Policy Update: Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
Currently, Anthem Blue Cross and Blue Shield includes Early and Periodic Screening, Diagnosis and Treatment (EPSDT) component services in the reimbursement of 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, refer to the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) reimbursement policy at https://mediproviders.anthem.com/wi.
October 2019 Anthem Provider News - Wisconsin