22-931m Screen Patients for ACEs and Get Paid

Date: 11/17/22

Help provide trauma-informed care for Medi-Cal patients with screenings and receive $29

Adverse Childhood Experiences (ACEs) are traumatic events that occur in childhood.  ACEs may include physical or emotional abuse, neglect, caregiver mental illness and household violence. ACEs can lead to poor health conditions such as asthma, diabetes, depression, heart disease and cancer. ACEs can also lead to social and behavioral issues, including poor social development, unhealthy behaviors or violence.

Screening for ACEs can help determine if a patient is at increased health risk due to a toxic stress response. Screening can also provide trauma-informed care for the member. Identifying and treating cases of trauma in children and adults can lower long-term health costs and support the well-being of individuals and families.

Payment criteria

On January 1, 2020, Medi-Cal providers became eligible for a $29 payment for conducting ACE screenings for Medi-Cal members, both children and adults. This payment is not available for:

• Patients ages 65 and older or
• Those who are dually eligible for Medi-Cal and Medicare Part B (regardless of enrollment in Medicare Part A or Part D).

Certified providers may be eligible to receive $29 for each ACEs screening conducted following the proper screening frequency and guidelines.

Get certified for ACEs screening

Visit ACEs aware to learn more on how to become a certified provider for ACEs screening or for resources on ACEs screening for your clinic.

Behavioral health treatment

Members who may benefit from behavioral health treatment can be referred to MHN. CalViva Health’s downstream subcontractor and Health Net’s* behavioral health administrator, MHN, provides behavioral health services to CalViva Health members.

For questions about referrals to MHN or to help your patients schedule an appointment with MHN, call 888-893-1569.

• Press “*” for mental health crisis.
  
• Press ”1” for member calls.
• Press “2” for provider calls including behavioral health

Additional information

Providers are encouraged to access the provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.

 

This information applies to Physicians and Participating Physician Groups (PPGs).

This information applies to Medi-Cal in Fresno, Kings and Madera counties.