Billing for CHDP Services

Billing for CHDP Services

For fee-for-service (FFS) physicians, Child Health and Disability Prevention (CHDP) program services are billed on a CMS-1500 form using appropriate CPT/HCPCS codes. The CHDP indicator "3" must be also entered in the box 24H (EPSDT/family planning) of the CMS-1500 to indicate that the visit was for CHDP services.

For capitated providers, CHDP program services must be submitted on an encounter to the participating physician group (PPG) for each visit.

Note that health assessment services are included in payment for the office visit and are not separately payable.