August 11, 2021

State of Alabama
Press Release: Medicaid

Rate Increase for Global Maternity Procedure Codes & Bonuses

PDF Version


TO:   All Delivering Healthcare Professionals (DHCPs)

 

RE:   Rate Increase for Global Maternity Procedure Codes & Bonuses

 

 

The Medicaid Agency is pleased to announce rate increases for global maternity procedure codes and Delivering Healthcare Professional (DHCP) bonus payments. Beginning with dates of service October 1, 2021, DHCPs will be reimbursed the following new rates for the specified procedure codes:

Procedure Code

Description

New Rate (for RURAL area providers)

New Rate (for URBAN area providers)

59400

Obstetrical Care

$2,090

$1,690

59409

Obstetrical Care

$1,640

$1,340

59410

Obstetrical Care

$1,690

$1,390

59510

Cesarean Delivery

$2,090

$1,690

59514

Cesarean Delivery

$1,640

$1,340

59515

Cesarean Delivery

$1,690

$1,390

59610

Vbac Delivery

$2,090

$1,690

59612

Vbac Delivery Only

$1,550

$1,250

59614

Vbac Care After Delivery Only

$1,600

$1,300

59618

Attempted Vbac Delivery

$2,090

          $1,690    

59620

Attempted Vbac Delivery Only

$1,600

$1,300

59622

Attempted Vbac After Care

$1,600

$1,300

Vbac- Vaginal birth after cesarean

 

Reimbursement for DHCP bonus payments will also increase. Beginning with dates of service October 1, 2021, DHCPs will be reimbursed for the specified DHCP bonus payments at the following new rates:

Procedure Code

Description

New Rate (for RURAL area providers)

New Rate (for URBAN area providers)

H1000

Prenatal Visit Bonus

$150

$150

G9357

Postpartum Visit Bonus

$150

$150

 

The prenatal bonus payment may be available to providers who render services to pregnant recipients within 90 days of the last menstrual period. The postpartum bonus payment may be available to providers who render services to recipients between 21-56 days after delivery. The DHCP bonus payment procedure codes must be billed on a separate claim for reimbursement.

 

Physicians will be reimbursed at 100% for the new global rates and DHCP bonus payments. Nurse practitioners, physician assistants, and nurse midwives will be reimbursed 80% of the physician rate for the new global rates and DHCP bonus payments.

 

For questions related to the new rates outlined above, you may e-mail ACHN@medicaid.alabama.gov.



The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2021 American Medical Association and © 2021 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.



  • For more information, visit http://medicaid.alabama.gov
  • For more state-wide press releases, click here