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TO: All Delivering Healthcare Professionals (DHCPs)
RE: Rate Increase for Global Maternity Procedure Codes & Bonuses
The Medicaid Agency is pleased to announce
rate increases for global maternity procedure codes and Delivering Healthcare
Professional (DHCP) bonus payments. Beginning with dates of service October 1,
2021, DHCPs will be reimbursed the following new rates for the specified procedure
codes:
|
Procedure
Code
|
Description
|
New Rate (for
RURAL area providers)
|
New Rate (for
URBAN area providers)
|
|
59400
|
Obstetrical Care
|
$2,090
|
$1,690
|
|
59409
|
Obstetrical Care
|
$1,640
|
$1,340
|
|
59410
|
Obstetrical Care
|
$1,690
|
$1,390
|
|
59510
|
Cesarean
Delivery
|
$2,090
|
$1,690
|
|
59514
|
Cesarean
Delivery
|
$1,640
|
$1,340
|
|
59515
|
Cesarean Delivery
|
$1,690
|
$1,390
|
|
59610
|
Vbac Delivery
|
$2,090
|
$1,690
|
|
59612
|
Vbac Delivery
Only
|
$1,550
|
$1,250
|
|
59614
|
Vbac Care After
Delivery Only
|
$1,600
|
$1,300
|
|
59618
|
Attempted Vbac
Delivery
|
$2,090
|
$1,690
|
|
59620
|
Attempted Vbac
Delivery Only
|
$1,600
|
$1,300
|
|
59622
|
Attempted Vbac
After Care
|
$1,600
|
$1,300
|
Vbac-
Vaginal birth after cesarean
Reimbursement for DHCP bonus payments will
also increase. Beginning with dates of service October 1, 2021, DHCPs will be
reimbursed for the specified DHCP bonus payments at the following new rates:
|
Procedure Code
|
Description
|
New Rate (for RURAL area providers)
|
New Rate (for URBAN area providers)
|
|
H1000
|
Prenatal
Visit Bonus
|
$150
|
$150
|
|
G9357
|
Postpartum
Visit Bonus
|
$150
|
$150
|
The prenatal bonus payment may be available
to providers who render services to pregnant recipients within 90 days of the
last menstrual period. The postpartum bonus payment may be available to
providers who render services to recipients between 21-56 days after delivery. The
DHCP bonus payment procedure codes must be billed on a separate claim for
reimbursement.
Physicians will be reimbursed at 100% for
the new global rates and DHCP bonus payments. Nurse practitioners, physician
assistants, and nurse midwives will be reimbursed 80% of the physician rate for
the new global rates and DHCP bonus payments.
For questions related to the new rates
outlined above, you may e-mail ACHN@medicaid.alabama.gov.
The Current Procedural Terminology (CPT) and Current Dental Terminology
(CDT) codes descriptors, and other data are copyright © 2021
American Medical Association and © 2021 American Dental Association (or such other date publication of CPT
and CDT). All rights reserved. Applicable FARS/DFARS apply.