During Well Visits, we perform routine health screenings recommended by the American Academy of Pediatrics and Bright Futures Guidelines.
These screenings are considered standard of care; failing to provide them would be to practice substandard medical care.
Insurance companies are supposed to cover these screenings. Unfortunately, not all of them do.
Most plans cover screenings at no cost to you. Some recommend the screenings, then pass on the cost to you by counting them toward your deductible or co-insurance. Some plans don’t cover these screenings at all.
If your insurance company doesn’t cover a standard screening, we suggest you call them, ask them why, and strongly urge them to start covering these standard services that benefit, and safeguard, your child’s health.
During your child’s visits, we may have to perform procedures or provide additional services to provide proper care. Insurance companies require us to bill these services and procedures separately, as additions to the “regular” office visit. As with screenings, most insurance companies cover these procedures and services most of the time. But some pass the costs to your deductible or co-insurance, and, again, some don’t cover them at all.
It’s Kids Plus policy to provide the best possible care for your child, no matter what insurance you have. We want to provide exceptional health care for your child, not pick and choose when we will and won’t provide care based on an insurance company’s policies. Because we accept thousands of different insurance plans, we can’t know or keep track of what every plan covers.
It’s your responsibility to understand what services are covered by your insurance plan.
A Sample of Services Performed at Well Visits
|Chlamydia Screening (yearly, 16-21 yrs)||87491/11363|
|Depression Screening (yearly, 12-17 yrs)||GO444|
|Edinburgh Post-Partum Screening (1, 2, 4, 6 mos)||96161|
|Exercise and Nutrition Counseling||G0447|
|Fluoride Varnish Protection (6, 9, 12, 15, 18, 24, 30, 36, 48 mos)||99188|
|Hearing and Vision Screening||92551-99173|
|Hemoglobin (9 mos, and onset of menarche for girls)||85018|
|Lead Screening (9, 24 mos)||83655|
|M-CHAT (9, 18, 24, 30 mos)||96110|
|Photo Screening – Vision Test (1, 2, 3, 4 yrs)||99177/99174|
|“Screen for Child Anxiety Related Disorders” Screening||96127|
A Sample of Some Additional Services and Procedures That May Be Billed With Your Visit
|Asthma Control test (ACT)||96160||Nebulizer Admin Set||A7003|
|Capillary Blood Draw||36416||Nebulizer Treatment||94640|
|Ceftriaxone Injection (Rocephin antibiotic)||J0696||Neurophysch Test Admin W/Comp||96120|
|Chemical Cautery, Tissue||17250||Neuropsychological Testing||96118|
|Clear Outer Ear Canal||69200||Office Emergency Care||99058|
|Treatment Nursemaid Elbow||24640||Preputial Stretching||54450|
|Control of Nosebleed||30901||Pulse Ox||94760|
|Destruct Lesion, 15 or more||17111||Rapid Flu||87502|
|Destruct Lesion, 1-14||17110||Removal of Sutures||S0630|
|Dexamethasone Sodium Phos (Decadron)||J1100||Incision/Remove Foreign Body SQ||10120|
|Evaluate Patient use of Inhaler||94664||Remove Impacted Ear Wax||69210|
|Face-to-Face Behavioral Counseling 15 Min||G0447||Remove Impacted Ear Wax Lavage||69209|
|Glucose Strip||82948||Removal of Skin Tags||11200|
|Immunotherapy Injection, Multiple||95117||Spirometry||94010|
|Immunotherapy One Injection||95115||Spirometry Pre/Post||94060|
|Post-Injury ImPACT Testing||96116||Strep A Assay W/Optic||87880|
|Incision of Tongue Tie||41010||TB Intradermal Test||86580|
|Initial Treatment of Burn(s)||16000||Throat Culture Screen||87081|
|Insert Bladder catheter||51701||Treatment of Burn(s)||16020|
|Measure Blood Oxygen Level||94761||Urine Screening||81002|
|Medication/Antibiotic Administration||96372||Evening/Weekend Hours||99051|
|Etonogestrel Implant (Nexplanon)||J7307|
|Insertion, Drug Delivery Implant||11981|
|Remove Drug Delivery Implant||11982|
|Removal w/ Reinsertion Drug Delivery Implant||11983|
If there’s a standard screening, service, or procedure you DON’T want, let us know.
Please understand that if you decline preventive screenings or treatments, you risk missing a preventable disease, or delaying treatment for a particular disease or condition, for your child.