HEDIS Provider Guide for Developmental Screening

This document is a HEDIS Provider Guide that outlines the requirements for developmental screening in children during their first three years of life. It specifies that the screening should assess risks of developmental, behavioral, and social delays using standardized tools within the 12 months preceding or on the child's first, second, or third birthday. The guide details the acceptable billing codes, including CPT 96110, and the modifiers that can be used. It emphasizes the importance of documenting the screening test date, the tool used, and the screening results in the medical record. Additionally, it lists various standardized screening tools recommended by the Bright Futures/American Academy of Pediatrics, which must meet specific criteria for reliability and validity. The guide also provides strategies for improving HEDIS scores, such as ensuring correct billing code capture and scheduling developmental screenings during pediatric visits.