Wisconsin Medicaid: Help children access preventive care
HealthCheck is a Wisconsin Department of Health Services (DHS) Medicaid benefit that covers most diagnostic and intervention services for beneficiaries ages 20 and younger. The goals of HealthCheck are to prevent illnesses and find and treat health issues early.
Here’s what you need to know about HealthCheck as you care for UnitedHealthcare Community Plan members:
What does HealthCheck cover?
Members ages 20 and younger who are enrolled in Wisconsin Medicaid, BadgerCare Plus or ForwardHealth are automatically covered for HealthCheck services, including:
- Periodic, comprehensive screening exams – also known as well-child checks – based on the American Academy of Pediatrics periodicity schedule
- Follow-up appointments, as needed
- Vision, hearing and dental services
- Immunizations
- Lab services
- Some prescription drugs, home health services and medical equipment, when medically necessary
Developmental and autism screenings
Two important parts of the HealthCheck benefit are developmental and autism screenings. Please adhere to the following guidelines for these screenings:
- Developmental screenings: Members should be screened for developmental, behavioral and social delays with a standardized global developmental screening tool by ages 1, 2 and 3
- Use CPT® code 96110
- Autism screenings: Members should be screened for autism by ages 18 months and 30 months
- Use CPT code 96110 and “CG” modifier or ICD-10 code Z13.41
Additional resources
See our behavioral health resources for screening tools, training and more.
DHS also offers a number of HealthCheck resources for health care professionals, including:
- Frequently asked questions
- Procedure codes
- Training
- Prior authorization requirements
You can also access the HealthCheck toolkit for resources to share with your patients.
Questions?
For questions specific to HealthCheck, contact DHS Provider Services at 800-947-9627.
For answers to questions about submitting a HealthCheck claim, chat with us 7 a.m.–7 p.m. CT from the UnitedHealthcare Provider Portal. You can also call UnitedHealthcare Provider Services at 877-842-3210.
CPT® is a registered trademark of the American Medical Association.
PCA-1-24-00102-POE-NN_01252024
