April 4, 2022

State of Alabama
Press Release: Medicaid

Nurse-Family Partnership (NFP)

PDF Version

TO:  All Providers

 

RE:   Nurse-Family Partnership (NFP)


The Alabama Medicaid Agency (Medicaid) received approval from the Centers for Medicare and Medicaid Services (CMS) for statewide coverage of Nurse-Family Partnership (NFP) related services effective January 1, 2022. NFP is a nationally recognized, evidence-based program that provides prenatal, postpartum and infant home visiting services until the child reaches age two.

Eligibility criteria for these services include Medicaid eligible women who are first-time mothers and/or have a high-risk pregnancy. High-risk pregnancy includes consideration of the mother’s age (less than 17 or older than 35), previous negative pregnancy outcomes, and those with existing medical conditions prior to becoming pregnant (e.g., high blood pressure, diabetes, sexually transmitted diseases).

 

Goals of the NFP program


·   Improving health outcomes for mother and child

·   Decreasing total Medicaid expenditures among families who receive NFP services

·   Increasing healthy spacing between births to 24 months

·   Reducing infant and maternal mortality

 

NFP has been available to Alabama families since 2008 through a grant from the Alabama Department of Early Childhood Education. Currently, three providers serve nine counties: NFP Easter Seals of West AL (Tuscaloosa); NFP of Central Alabama (Jefferson, Walker and Fayette); and Gift of Life NFP (Autauga, Elmore, Macon, Montgomery, and Russell).

 

Providers interested in the NFP Program


·  Email Matthew Richardson from the National Service Organization (NSO) at matthew.richardson@nursefamilypartnership.org to learn about the NFP provider certification process.

·  NFP certification must be completed before enrolling as a NFP provider with Medicaid.

·  Additionally, NFP providers will be required to pay an application fee in compliance with CMS requirements.

·   Eligible NFP providers can enroll in Medicaid via the Electronic Provider Enrollment Application Portal beginning on April 1, 2022 at https://medicaid.alabama.gov/content/10.0_Contact/10.3_Provider_Contacts/10.3.4_Provider_Enrollment.aspx.

·   Resource to assist NFP providers with the online application:  https://medicaid.alabama.gov/documents/5.0_Managed_Care/5.3_NFP/5.3_NFP_Resource_Provider_Enrollment_4-1-22.pdf.


Reimbursement Information

NFP services will be reimbursed once per month, per participating family unit/NFP Client ID in the amount of $765.47. The first date of service eligible for payment will be July 1, 2022.

 

Below are the procedure combinations to include on claims for NFP reimbursement:

 

Procedure Code

*Modifier

*Modifier

Applicable Service

T2023

HD

U1

Prenatal

T2023

HD

U2

Postpartum

T2023

HD

U3

Infant/Child

*Use of both modifiers will be required for reimbursement.

Additional information is required for claims submission (this information will be listed in the July 2022 edition of the Alabama Medicaid Provider Billing Manual. Claims paid in error will be subject to recoupment.


For more information related to the NFP Program, please visit https://medicaid.alabama.gov/content/5.0_Managed_Care/5.3_Nurse-Family_Partnership.aspx.

 

The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2022 American Medical Association and © 2022 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
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