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​Developmental screening for Keystone HMO CHIP members

December 13, 2021

T​he Pennsylvania Department of Human Services (DHS) states that all children enrolled in Keystone Health Plan East HMO Children’s Health Insurance Program (Keystone HMO CHIP) should receive valid developmental screening regardless of risk level.

Screening and documentation are especially important for c​​hildren enrolled in Keystone HMO CHIP because of the higher incidence of developmental delay among certain pediatric populations enrolled in government-sponsored programs when compared to children enrolled in privately insured plans.

Screening and documentation for developmental screening

Practitioners are encouraged to follow the PA DHS and Bright Futures™ guidelines for developmental screening and documentation. Guidelines include:

  • Complete formal screening for developmental delays at ages 9, 18, and 30 months even when there are no concerns. Screen more often if there are concerns or additional risk factors.
  • Perform the screening using validated screening tools. Validated screening tools for developmental delays can be found on the Bright Futures website:
  • Use CPT® code 96110 to report the completion of developmental screening using standardized and validated screening tools. 
  • Add screening documentation to the member's chart and claim submissions.​

Resources

The following resources provide additional information regarding developmental screening recommendations: 

​CPT Copyright 2017 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.


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