September 01, 2022

Wisconsin Medicaid: Help children access preventive care

HealthCheck is a Wisconsin Department of Health Services (DHS) Medicaid benefit that covers most diagnostic and intervention services for beneficiaries ages 20 and younger. The goal of HealthCheck is to prevent illnesses and find and treat health issues early.

Here’s what you need to know about HealthCheck as you care for UnitedHealthcare Community Plan members:

What does HealthCheck cover?
Members ages 20 and younger who are enrolled in Wisconsin Medicaid, BadgerCare Plus or ForwardHealth are automatically covered for HealthCheck services, including:

  • Periodic, comprehensive screening exams – also known as well-child checks – based on the American Academy of Pediatrics periodicity schedule
  • Follow-up appointments as needed
  • Vision, hearing and dental services
  • Immunizations 
  • Lab services 
  • Some prescription drugs, home health services and medical equipment when medically necessary

Developmental and autism screenings
Developmental and autism screenings are an important part of the HealthCheck benefit. Please be sure to adhere to the following guidelines for these screenings:

  • Developmental screenings: Members should be screened for developmental, behavioral and social delays with a standardized global developmental screening tool by ages 1, 2 and 3
    • Use CPT® code 96110 
  • Autism screenings: Members should be screened for autism by ages 18 months and 30 months
    • Use CPT code 96110 and “CG” modifier or ICD-10 code Z13.41

Additional resources
See our behavioral health resources for screening tools, training and more. 

DHS also offers a number of HealthCheck resources for health care professionals, including frequently asked questions, procedure codes, training and prior authorization requirements. You can also access the HealthCheck toolkit for resources to share with your patients. 

CPT® is a registered trademark of the American Medical Association.
PCA-1-22-02171-C&S-News_08152022
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