Appendix 19 - Medicaid Maximum Fee Schedule for Prenatal Care Coordination Services - Text Only Version for the Prenatal Care Coordination Services Handbook, Wisconsin Medicaid

Prenatal Care Coordination Services Handbook
Appendix 19

Medicaid Maximum Fee Schedule for Prenatal Care Coordination Services

The following reimbursement rates are effective as of July 1, 2000. The reimbursement rates are subject to change. To obtain the most current reimbursement rates in the future, providers may:

Purchase a paper schedule by writing to:
Wisconsin Medicaid
Provider Maintenance
6406 Bridge Road
Madison, WI 53784-0006
Download an electronic version from Wisconsin Medicaid’s Web site at dhs.wisconsin.gov/medicaid/ using instructions found in the Claims Submission section of the All-Provider Handbook.

The following limitations apply:

The limit for prenatal care coordination (PNCC) services (W7090-W7094) is $868.60 per recipient, per pregnancy.
The limit for ongoing care coordination and monitoring, health education, and nutrition counseling (procedure codes W7092-W7094) is $774.02 per recipient, per pregnancy.

Maximum allowable fees are effective as of July 1, 2000.

Procedure Code	Procedure Description	Maximum Allowable Fee
W7090	Risk Assessment	$47.29
W7091	Initial Care Plan Development	$47.29
W7092	Ongoing Care Coordination and Monitoring	$31.52
W7093	Health Education/Nutrition Counseling - Individual	$31.52
W7094	Health Education/Nutrition Counseling - Group	$6.30

Providers are required to bill their usual and customary charges for services provided.

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Prenatal Care Coordination Services Handbook Appendix 19

Medicaid Maximum Fee Schedule for Prenatal Care Coordination Services

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

Prenatal Care Coordination Services Handbook
Appendix 19

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