MedicaidCoverageMedium impact
Mental Health and Substance Abuse Screening, Preventive Mental Health Counseling, and Substance Abuse Intervention for Pregnant Women: A New Benefit Under BadgerCare Plus and Wisconsin Medicaid
Wisconsin Medicaid (ForwardHealth)·WI · OB-GYN, Family Medicine, Psychiatry·Medical Policy
Effective date
Feb 1, 2008
We identified it
Jun 20, 2026
Summary
Wisconsin Medicaid and BadgerCare Plus now cover mental health and substance abuse screening, preventive counseling, and intervention services for pregnant women. New billing codes H0002 and H0004 with specific modifiers HE and HF are required for these services.
Action Required
By February 1, 2008: Billing team must add new HCPCS codes H0002 (with modifiers HE for mental health screening, HF for substance abuse screening) and H0004 (with modifiers HE for mental health counseling, HF for substance abuse intervention) to billing system for pregnant women enrolled in Wisconsin Medicaid and BadgerCare Plus. Update encounter forms for eligible providers. Screen limited to one unit per pregnancy, counseling limited to 4 hours (16 units) per pregnancy.