Child Health Check-Up (CHCUP) is available to every Medicaid-eligible child
under age (21). It includes screening (or well-child check-ups), diagnosis and
treatment.
To provide Child Health Check-Ups, a provider must be enrolled in Medicaid as a
provider with a Category of Service (code 55) for Child Health Check-Ups.
As licensed health care professionals you are aware that performing a blood
test is a federal requirement at specific intervals during the “Child
Health Check-Up.” This note is to remind you how important it is to
document the blood tests you are performing in compliance with this federal
mandate. Failure to provide documentation can lead to a federal audit and
the requirement to repay Medicaid for fees received.
The Child Health Check-Up schedule is:
Birth or neonatal examination
(2-4) days for newborns discharged in less than (48) hours after
delivery
By (1) month
(2) months
(4) months
(6) months
(9) months
(12) months
(15) months
(18) months
Once per year for (2) through (20) year olds*
The child may enter the periodicity schedule at any time. For example, if a
child has an initial screening at age (4), then the next periodic screening is
performed at age (5).
* Florida Medicaid recommends check-ups at (7) and (9) years of age for those
children at risk.
Vaccines for Children
The Centers for Disease Control and Prevention (CDC), which provides Vaccines
for Children (VFC) funding, has developed strict accountability requirements
from the state, local health jurisdictions, and individual providers. Molina
Healthcare Providers should be enrolled in the VFC program through their local health department. State supplied vaccines are provided at no cost to
enrolled providers through the local health department. Florida is a “universal
vaccine distribution” state. This means no fees can be charged to patients for
the vaccines themselves and no child should be denied state supplied vaccines
for inability to pay an administration fee or office visit.
Molina Healthcare follows AHCA billing guidelines for reimbursing a provider’s
administration costs. We reimburse per Florida’s fee schedule. Providers must
bill state-supplied vaccines with the appropriate procedure codes.
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