Prior to implementation of the Patient Protection and Affordable Care Act (PPACA), some payer policies limited benefits for preventive medicine services such that the 3- to 5-day service was not recognized for coverage as a preventive medicine service. In other instances, preventive medicine services were denied later in an infant’s first year of life due to maximum benefits reached. Many private payers now publish preventive service coverage determination policies that specify coverage of wellness examinations per the Bright Futures/American Academy of Pediatrics (AAP) “Recommendations for Preventive Pediatric Health Care” (periodicity schedule) (www.aap.org/periodicityschedule) and the Discretionary Advisory Committee on Heritable Disorders in Newborns and Children “Recommended Uniform Screening Panel” (http://1.usa.gov/1lGudQc) as required by the PPACA (referenced by some plans as the AAP and American Academy of Family Physicians age and frequency guidelines). Based on the 2014 periodicity schedule, the 3- to 5-day visit is 1 of 6...

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