Rule 23-223-1.8 - ReimbursementA. The Division of Medicaid reimburses a separate fee in addition to the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) periodic screenings and medically necessary interperiodic visits for each of the following when documented in accordance with Miss. Admin. Code Title 23, Part 223, Rule 1.6.A. 1. Developmental screenings according to the American Academy of Pediatrics (AAP) guidelines,5. Depression screenings,6. Maternal depression screening, and7. Other medically necessary services prior authorized by the Division of Medicaid or designee, if required: a) Lab tests, excluding hemoglobin or hematocrit,B. The Division of Medicaid reimburses EPSDT screening fees using Current Procedural Terminology (CPT) Codes based on the American Medical Association (AMA) methodology for determining medical services at the same rate that was in effect for State Fiscal Year (SFY) 2021.C. The Division of Medicaid only reimburses Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC) and Mississippi Department of Health (MSDH) Clinics an encounter rate that is all inclusive of all items listed in Miss. Admin. Code Title 23, Part 223, Rule 1.8.A. 23 Miss. Code. R. 223-1.8
42 U.S.C. § 1396d; 42 C.F.R Part 441, Subpart B; Miss. Code Ann. §§ 43-13-117, 4313-121.Revised to correspond with SPA 2015-017 (eff. 11/01/2015)