The American Academy of Pediatrics (AAP) continues to advocate for payment for limited developmental screening (Current Procedural Terminology [CPT®] code 96110). Several commercial payers and state Medicaid programs continue to inappropriately bundle these services with an evaluation and management (E/M) service. However, the good news is that because of AAP private payer advocacy efforts as well as the work of AAP chapter pediatric councils, many payers are now paying separately for CPT code 96110.
The AAP has developed a list of commercial payers that pay for or continue to bundle CPT code 96110 (Table 1). This list is derived from information from carrier contacts or from AAP members through the AAP Hassle Factor Form and the Section on Administration and Practice Management and pediatric council electronic mailing lists.
By not acting, your practice will be affected as indicated in Table 2.