​Postpartum Depression Screening During an EPSDT Well-Child Visit as of January 1, 2018

Idaho Medicaid follows the American Academy of Pediatrics “Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents.” Please see the updated Idaho MMIS Provider Handbook, General Provider and Participant Information, section on Wellness Exams. The recommended maternal depression screening is a benefit for the child and part of the Early & Periodic Screening, Diagnostic & Treatment (EPSDT) visit benefit billed to Molina HealthPas MMIS (not the IBHP plan).

During a Well-Baby visit for an infant, the Department encourages screening of new mothers for postpartum depression. The codes can be submitted with the Well-Baby visit under the infant’s Medicaid ID number.
Use one of the two new codes to indicate the screening results of a positive or negative result:

• G8431 will be used to code for a positive depression screen
• G8510 will be used to code for a negative depression screen 

These codes are effective as of January 1, 2018. Medicaid reimbursement $10.28 per screening. The available limit is three (3) screenings per infant under twelve (12) months of age. See the American Academy of Pediatrics Bright Futures Periodicity Table for a recommended schedule.

Please follow the guidelines below when billing G8431 or G8510: 

• Bill only when one of the standardized screening instruments is used:
• Edinburgh Postnatal Depression Scale (EPDS)
• Patient Health Questionnaire – 9 (PHQ-9) Screener
• Beck Depression Inventory (BDI)
• Bill using the child’s Idaho Medicaid participant ID number. Claims billed under the mother's Medicaid ID number will be denied.