[site map]

Child Care Coordination Services Handbook
Appendix 4

Medicaid-Allowable Procedure Codes and Modifiers for Child Care Coordination Services

Procedure Codes

Procedure	Description
W7095	Risk Assessment - Child Care Coordination (See modifiers below)
W7096	Initial Care Plan Development - Child Care Coordination
W7097	Ongoing Child Care Coordination and Monitoring

Risk Assessment (Family Questionnaire) Score Modifier

The risk assessment (Family Questionnaire) must be billed using the appropriate two-digit modifier to indicate the recipient’s total risk assessment score. Claims for risk assessments that are submitted without a modifier are denied. The modifiers in the gray cells represent modifiers for recipients who do not qualify for child care coordination (CCC) services. Providers do not need to use modifiers with other CCC procedure codes.

Score	Modifier	Score	Modifier	Score	Modifier	Score	Modifier
00-09	00	80-89	08	160-169	16	240-249	24
10-19	01	90-99	09	170-179	17	250-259	25
20-29	02	100-109	10	180-189	18	260-269	26
30-39	03	110-119	11	190-199	19	270-279	27
40-49	04	120-129	12	200-209	20	280-289	28
50-59	05	130-139	13	210-219	21	290-299	29
60-69	06	140-149	14	220-229	22	300 or greater	30
70-79	07	150-159	15	230-239	23

[site map] [top]

Wisconsin Medicaid Handbook list
Wisconsin Department of Health and Family Services
Wisconsin Medicaid and BadgerCare