MedicaidBilling CodesMedium impact
24-589 Expanded Prenatal Screening Program
Health Net·CA · OB-GYN, Family Medicine·Reimbursement
Effective date
Apr 1, 2024
We identified it
Jun 20, 2026
Summary
Effective April 1, 2024, California's Prenatal Screening Program expanded to include sex chromosome aneuploidy screening (X, XXY, XYY, XXX) in addition to existing trisomy screening. Providers must use updated CPT code 81420 for the expanded screening panel and ensure referrals go to PNS Program-contracted labs for coverage.
Action Required
Immediately: Update billing system to use CPT code 81420 for fetal chromosomal aneuploidy screening that now includes sex chromosome screening. Ensure all prenatal genetic screening referrals use PNS Program-contracted labs and the required PNS Program referral form available on their website. Update encounter forms to include diagnosis code Z360 for antenatal screening. Verify blood draw supply orders use forms from PNS Program website.