Tsev Kev Txheeb Xyuas Txog Kev Them Nqi Rau Chaw Yug Me Nyuam Lwm Hom​​ 

Kev Txheeb Xyuas Txog Kev Them Nqi Rau Chaw Yug Me Nyuam Lwm Hom​​ 

Daim Ntawv Qhia Txog Qhov Tseeb: Cov Kev Cai Them Nqi Rau Kev Pabcuam ntawm Lwm Lub Chaw Yug Me Nyuam Medi-Cal​​ 

Txawm hais tias Medi-Cal cov phiaj xwm kev kho mob uas tswj hwm (MCP) yuav tsum muab cov txiaj ntsig zoo ib yam li Medi-Cal FFS thiab feem ntau siv cov lej them nqi Medi-Cal FFS, qee cov Medi-Cal MCPs yuav muaj kev tswj hwm kev siv thiab cov cai them nqi sib txawv. Yog li ntawd, cov kws pab yug menyuam yuav tsum lees paub cov cai no nrog txhua tus Medi-Cal MCP uas lawv tau cog lus los muab kev pabcuam rau cov tswv cuab Medi-Cal.​​   

Kev Tsim Nyog Rau Tus Nqi Rau Chaw Yug Me Nyuam Lwm Hom​​ 

  • Cov Chaw Yug Me Nyuam Lwm Hom (ABCs) (APL 26-005; APL 15-017) yog California qhov sib npaug ntawm cov chaw yug me nyuam ywj pheej (FBCs), uas yog cov chaw kho mob tshwj xeeb uas tau tso cai rau Medi-Cal them nqi rau kev pab yug me nyuam thiab yug me nyuam (Alternative Birthing Centers (alternative)), nrog rau Comprehensive Perinatal Services Program (CPSP).​​ 
  • Cov ABCs uas muaj daim ntawv tso cai yuav siv HCPCS Z7516 rau tus nqi them thoob ntiaj teb, txwv rau ib qho rau ib cev xeeb tub (6-lub hlis), yog tias yug menyuam tshwm sim ntawm ABC.​​ 
  • Yog tias tus neeg mob pib yug menyuam ntawm ABC tab sis tom qab ntawd raug xa mus rau tsev kho mob kom yug menyuam, tus neeg mob uas muaj daim ntawv tso cai ABC tuaj yeem siv HCPCS Z7516 nrog modifier 52 thiab tau txais nyiaj rov qab ib feem ntawm tus nqi tag nrho ntawm qhov chaw (Alternative Birthing Centers (alternate)).​​ 
  • Tus nqi them rau qhov chaw kho mob (Z7516) kuj tseem tuaj yeem raug them ncaj qha rau tus kws pab yug menyuam uas muaj ntawv tso cai (LM) lossis tus kws saib xyuas neeg mob uas muaj ntawv pov thawj (CNM) uas yog tus tswv raug cai ntawm ABC, rau cov kev pabcuam tshaj lij uas ua tiav los ntawm LM lossis CNM ntawm ABC.​​ 

Kev Them Nqi Rau Cov Menyuam Yug Tshiab​​ 

  • Cov kev pab cuam rau cov menyuam mos tshiab raug them nqi sib cais ntawm leej niam txoj kev yug menyuam.​​ 
  • Piv txwv li, ib tug LM/CNM tuaj yeem sau nqi rau kev saib xyuas thawj zaug, ib hnub, rau kev ntsuam xyuas thiab kev tswj hwm (E&M) ntawm ib tug menyuam mos uas yug tshiab siv 99460, thiab 99463 rau kev saib xyuas thawj zaug, ib hnub, rau E&M ntawm ib tug menyuam mos uas tau txais thiab tawm hauv tib hnub ntawd.​​ 
  • Tus LM/CNM tuaj yeem sau nqi siv 99461 rau kev saib xyuas menyuam mos thawj zaug uas ua hauv tsev lossis lwm qhov chaw, sab nraum tsev kho mob lossis ABC uas tau tso cai.​​ 
  • Tsis tuaj yeem them tus nqi pabcuam rau tus menyuam mos sib cais, ntxiv rau tus nqi pabcuam rau leej niam. HCPCS Z7516 tsuas yog siv rau leej niam yug menyuam thiab siv chaw zov menyuam xwb.​​ 

Kev yug menyuam hauv tsev nrog rau kev ntsuam xyuas menyuam mos​​ 

  • Thaum yug me nyuam hauv tsev nrog tus kws pab yug me nyuam (LM/CNM), tus kws pab yug me nyuam tuaj yeem sau nqi rau kev yug me nyuam los ntawm qhov chaw mos siv 59409 tab sis tsis tuaj yeem sau nqi rau tus nqi chaw kho mob (Z7516). Yog tias tus kws pab yug menyuam kuj ua tiav qhov kev ntsuam xyuas menyuam mos tom qab yug menyuam, ces 99461 tuaj yeem siv los them nqi.​​  

Kev yug menyuam hauv Chaw Yug Me Nyuam uas tsis tau dhau los ntawm CDPH Daim Ntawv Tso Cai nrog Piv Txwv Kev Ntsuam Xyuas Menyuam Mos​​ 

  • Thaum tus kws pab yug menyuam yug menyuam ntawm lub chaw yug menyuam uas tsis muaj daim ntawv tso cai (piv txwv li, ib qho uas tsis tau dhau los ntawm CDPH cov txheej txheem tso cai), cov nqi kho mob tuaj yeem raug them rau kev yug menyuam siv 59409 thiab kev ntsuam xyuas menyuam mos tom qab yug tuaj yeem raug them siv 99461. Tsis tas li ntawd xwb, tus nqi siv rau qhov chaw kuj tseem yuav raug them los ntawm kev siv Z7516 los ntawm LM/CNM uas yog tus tswv raug cai ntawm ABC.​​ 

Piv txwv ntawm Kev Xeem Kev Yug Me Nyuam Hauv Chaw Yug Me Nyuam Uas Muaj Daim Ntawv Tso Cai​​ 

  • Thaum tus kws pab yug menyuam yug los ntawm qhov chaw mos ntawm ABC uas tau tso cai, tus kws pab yug menyuam tuaj yeem sau nqi rau kev yug menyuam los ntawm qhov chaw mos siv 59409, nrog rau tus nqi chaw kho mob Z7516. Tus kws pab yug menyuam ua tiav qhov kev ntsuam xyuas menyuam mos thawj zaug tom qab yug los ntawm ABC thiab them nqi siv 99463 vim tias tus tswv cuab thiab menyuam mos tawm hauv 24 teev tom qab yug menyuam.​​