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Developmental Screenings

General vs. Domain-Specific Developmental Screening for Pediatric Patients

Early identification and intervention for developmental disorders are critical to the well-being of children. Pediatricians and Family Practice physicians have more opportunities to screen and observe infants and toddlers for delays than any other professional within the first 3 years of life based on the American Academy of Pediatrics (AAP) Periodicity Schedule.

NEW MEASURE FOR THE QUALITY CARE INCENTIVE PROGRAM (QCIP)!

CenCal Health added “Developmental Screening in the First Three Years of Life” to QCIP to improve the percentage of CenCal Health children who received a general developmental screening by age 1, age 2, and age 3.

Services rendered beginning July 2024 will be used to calculate QCIP incentive payments when developmental screening transitions to a priority measure in July 2025, with the first incentive distribution in Q3 2025.

General developmental screening must be performed using a validated tool to identify children at risk of cognitive, motor, communication, or socialemotional delays that may require further evaluation.

Note: A targeted developmental screening may be performed when indicated, such as to screen for social emotional development delays or autism. In those instances, domain-specific screening tools are required.

Validated Tools for General Developmental Screening

Some examples of appropriate tools to use include:

  • Ages and Stages Questionnaire – 3rd Edition (ASQ-3)
  • Parents’ Evaluation of Developmental Status (PEDS) – Birth to age 8
  • Parent’s Evaluation of Developmental Status – Developmental Milestones (PEDS-DM)
  • Survey of Well-Being in Young Children (SWYC: milestones)

Validated Tools for Domain-Specific Screening

Some examples of appropriate tools to use when indicated by at-risk scores on general developmental screenings, through surveillance, or other identified risk factors:

  • Ages and Stages Questionnaire: Social-Emotional – 2nd Edition (ASQ-SE)
  • Modified Checklist for Autism in Toddlers Revised with Follow-Up (M-CHAT)
  • Survey of Well-Being in Young Children (SWYC: Baby PSC)
  • Survey of Well-Being in Young Children (SWYC: Preschool PSC)

Billing

A general and a domain-specific screening may be billed on the same day if the correct codes and modifiers are used. Screenings may be billed as follows:

Type of Screening CPT codes & Modifiers
General Developmental Screening
To be completed at 9, 18, and 30 months per the AAP Periodicity
Schedule and when medically necessary based on surveillance
$ – Under Proposition 56, PCPs can earn a supplemental incentive payment
for developmental screenings
96110

Domain-Specific Screening
Per AAP Periodicity Schedule or if indicated based on surveillance/risk

 

 

  • Behavioral & emotional problems @ 9, 18, 30 months
  • Autism Spectrum Disorder (ASD) @ 18, 24 months

96127

96110 with modifier KX

 

Tips for Implementing a Screening Process:

For more details and to download a helpful worksheet, please click here:

  • Identify screening tools currently used in your practice
  • Identify a screening champion within your practice
  • Identify practice team members that will be part of the screening process
  • Select screening tool(s) and educational materials to be used
  • Plan key steps of the workflow/process
  • Identify program supports and resources (partners and materials)
  • Plan how to engage staff in the process

Additional Resources:

  • AAP Periodicity Schedule: Please click here
  • “Promoting Optimal Development: Identifying Infants and Young Children with
    Developmental Disorders Through Developmental Surveillance and Screening”: Please click here
  • CenCal Health Member-facing materials to support your patients:

For questions or to schedule a collaborative call, please contact the Population Health team at:
populationhealth@cencalhealth.org.