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L.A. Care Health PlanMedicaid · Documentation · Medical Policy · CA · OB-GYN, Family Medicine, PediatricsHigh impact

Maternal Mental Health Screening Requirement Update

Act
immediately
Effective date
Jun 2, 2026
Identified
Jun 20, 2026

Summary

L.A. Care Health Plan requires providers to conduct and document maternal mental health screenings during pregnancy and postpartum using validated tools like EPDS or PHQ-9, with specific billing codes for enhanced HEDIS reporting. Positive screens must have documented follow-up within 30 days and appropriate referrals within 10 days.

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What to do

immediately · 4 steps
01Providers must implement maternal mental health screening protocols using CPT 96127, HCPCS G0444, G8431, G8510, and ICD-10 Z13.31, Z13.32 for proper documentation and HEDIS reporting.
02Update EMR templates to include Edinburgh Postnatal Depression Scale (EPDS) or PHQ-9 screening tools during pregnancy (first trimester recommended), within 6 weeks postpartum, and at infant well-child visits at 1, 2, 4, and 6 months.
03Establish referral workflows to Carelon Behavioral Health (877-344-2858) for mild-moderate cases within 10 days and LA County DMH (800-854-7771) for high-level needs.
04Document all screening scores and ensure 30-day follow-up for positive screens to avoid compliance issues.

Codes mentioned

96127G0444G8431G8510Z13.31Z13.32

Original notice

Maternal Mental Health Screening Requirement Update
lacare.org · Always check the source before changing claims.
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Related changes

See all L.A. Care Health Plan changes →
Maternal Mental Health Screening RequirementsHighEffective Jun 17, 2026 · Medical PolicyMaternal Mental Health Screening RequirementsMediumEffective Jan 1, 2025 · Medical PolicyBrowse every L.A. Care Health Plan change in the policy list

Related policy hubs

L.A. Care Health Plan policiesCA policy changesOB-GYNFamily MedicinePediatricsCode 96127Code G0444Code G8431Code G8510Code Z13.31Code Z13.32

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