MedicaidBilling CodesMedium impact
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Molina Healthcare·MS · Pediatrics, Family Medicine, General Practice·Provider Bulletin
Effective date
Apr 1, 2026
We identified it
Aug 15, 2026
Summary
Molina Healthcare of Mississippi provider newsletter (Q2 2026) introduces Care Connections, a nurse practitioner-led care coordination program offering telehealth and in-person visits at no cost to members. Key billing impact: CPT 96110 must be used ONLY for global developmental screenings (not domain-specific tools like M-CHAT or ASQ:SE) for children ages 1-3, with specific ICD-10 codes required for proper HEDIS measure compliance.
Action Required
Effective immediately for Q2 2026 billing: (1) Billing team must update EMR/billing system to enforce that CPT 96110 is submitted ONLY for global developmental screening tools (ASQ, PEDS) and NEVER for domain-specific tools (M-CHAT, ASQ:SE). Claims using 96110 for domain-specific tools will not count toward DEV-CH and should be excluded. (2) Providers must document the screening tool name, date, score/result, clinical interpretation, and recommendations in all well-child visit notes for children ages 1-3. (3) Update encounter forms and clinical documentation templates to require both Z13.42 (Screening for global developmental delays) and Z00.129 (Routine child health exam) coding for eligible visits. (4) Provider Relations Representatives should educate clinical staff on proper coding to avoid claim rejections and ensure HEDIS measure compliance. (5) For Care Connections visits, ensure visit records are accessible via EpicCare Link portal at CCLink.MolinaHealthcare.com for care coordination documentation.