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States Try Innovative Approaches to Identify and Treat Maternal Depression

November 17, 2014

By Sophia Duong

Maternal depression imposes serious risks to a child’s development, as Dr. Olivia Golden from the Urban Institute noted in a previous blog post. Dr. Golden not only covers the effects on children’s cognitive, psychosocial, and behavioral development, she also cites that maternal depression is highly prevalent among low-income mothers. Without treatment, mothers and children may suffer long-term consequences. Fortunately, some states are taking creative approaches to get more mothers screened for depression, which is the first step to accessing treatment.

At least five states – Colorado, Illinois, Minnesota, North Dakota, and Virginia –reimburse pediatric primary care providers for maternal depression screenings under the child’s Medicaid ID number, if the screening is done at an infant’s well-child visit or other pediatric visit. Maternal depression screenings are considered a “risk assessment” for the child, and screenings must be done with approved standardized screening tools. See more details in the table below.

 

Colorado
  • Pediatric primary care providers who see infants for well-baby visits may now bill for postpartum depression screening on the mother using the infant’s Medicaid ID
Illinois (also see Reducing Maternal Depression and Its Impact on Young Children, pg. 15)
  • If the postpartum depression screening occurs during a well-child visit or episodic visit (infrequent acute care) for an infant under age one, the screening will be billed under the infant’s Medicaid ID
  • Screenings may be done as many times as necessary, up to one year after birth
  • If a mother is diagnosed with depression, then Medicaid will reimburse for antidepressants or other pharmacological treatment under the woman’s ID, only if the woman is enrolled in Medicaid or another program run through the IL Department of Healthcare and Family Services (HFS)
  • If a mother is diagnosed with depression but not eligible for a HFS medical program, then a provider may refer her to mental health resources
Minnesota
  • Maternal depression screenings are covered as a Child & Teen Checkup Service (MN’s EPSDT program) or at other pediatric visits within the child’s first year, and billed on the same claim as these services
  • MN allows up to three maternal depression screenings for a mother of a child under one year of age
North Dakota
  • When the maternal depression screening occurs during a Health Tracks screening (EPSDT) or other pediatric office visit for an North Dakota Medicaid-eligible child under one year of age, providers may bill using the child’s Medicaid ID
  • ND Medicaid allows up to three maternal depression screenings for a child under the age of one
Virginia
  • Through VA’s BabyCare program pediatric providers may be reimbursed for administering the Behavioral Health Risks Screening Tool, which screens for postpartum depression, substance abuse, and intimate partner violence
  • Screening may be billed under the infant’s Medicaid benefit up to age two

*Two of these states, IL and MN, received support to implement these practices through the Assuring Better Child Health and Development Project.

More experts are recognizing the importance of involving pediatricians in maternal depression screening. In fact this report from the American Academy of Pediatrics (AAP) recommends that primary care pediatricians integrate maternal depression screening within their care for infants, and states that the majority of pediatricians agree that maternal depression screenings are within their scope of practice. Other states and child health advocates may want to take notice of the innovative approaches CO, IL, MN, ND, and VA have already implemented.

 

 

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