The EDOPC Project
The Enhancing Developmentally Oriented Primary Care (EDOPC) Project was a 3–year project that began in 2005 with the goal of improving preventive health and developmental services for children birth to 3 in Illinois. The project involved a collaborative partnership of the Illinois Chapter of the American Academy of Pediatrics, the Advocate Health System’s Healthy Steps for Young Children Program, the Illinois Academy of Family Physicians, and the Ounce of Prevention Fund.
The primary objectives of the EDOPC project included increasing the number of
- primary care clinicians using validated tools for developmental screening with all children by the 1–year well-child visit
- primary care clinicians who had established at least three referral relationships with early intervention and family case management services, local public health departments, and other providers of developmental and social–emotional services
- referrals of children who were identified as at-risk through developmental and social-emotional screenings for further evaluation and follow-up
- parents who reported being asked by clinicians about their concerns regarding their child’s development and behavior
Go to the ICAAP web site
for more reimbursement tips.
In office-based presentations to primary care clinicians, EDOPC trainers provided instruction on using Ages & Stages Questionnaires® (ASQ®) and Ages & Stages Questionnaires®: Social–Emotional (ASQ®:SE).
According to Anita Berry, director of the Healthy Steps for Young Children program, many physicians’ practices found the pictures that illustrate the individual ASQ and ASQ:SE questionnaires to be “really helpful,” making them “easier for parents to understand.”
EDOPC’s Strategies to Increase Reimbursement for Screening
EDOPC and the Illinois chapter of the American Academy of Pediatrics (ICAAP) also wanted to promote the routine use of screening tools by increasing awareness of opportunities for providers to bill for screening services. Here is what the projects learned about ways physicians could receive reimbursments for screening with ASQ and ASQ:SE in Illinois:
- Physicians could receive enhanced reimbursement for screening by becoming a Maternal and Child Health provider.
- Physicians who implemented screening consistently and billed all patients for the service were eligible to receive reimbursement for screening of patients on public aid programs such as Medicaid.
- Physicians were encouraged to inform ICAAP of private insurers that did not reimburse for developmental screening so that the chapter could advocate for coverage.
- Physicians were made aware that the code for developmental screening and social-emotional screening was 96110; the reimbursement amount was $16.10 for each developmental or social-emotional screen.