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Attention providers:
What is changing?
The Health Care Authority (HCA) has published a revised EPSDT Well-Child Program Billing Guide, effective January 1, 2025.
Revisions to this guide include the following additions:
- Social determinants of health risk assessment (SDoH) as a required element for a well-child checkup
- Information about using ICD-10-CM diagnosis codes when submitting claims for developmental and behavioral health screenings with dates of service on or after July 1, 2025.
- Information about using modifier SL for vaccine procedure codes for vaccines given in a nonfacility setting
See the What has changed? table in the revised guide for further details or contact the Apple Health Clinical Inbox with any questions.
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