Depression is one of the most common medical complications women can face during pregnancy and the postpartum period. Untreated depression has been associated with poor pregnancy outcomes, including fetal growth restrictions and preterm birth.
The American College of Obstetricians and Gynecologists (ACOG), the United States Preventive Services Task Force (USPSTF), and the NYS Medicaid Prenatal Standards recommend screening women for depression, referring them for care as needed, and following up with those who screen positive for depression.
CDPHP urges you to:
- Schedule mothers for a postpartum visit between 21 and 56 days after delivery.
- Encourage patients to sign an exchange of information (EOI) form.
- Screen pregnant women as part of their routine care using an age-appropriate, standardized depression screening tool, such as the PHQ-2 or PHQ-9.
- If the depression screen is positive, document a follow-up plan on the date of the positive screen. Be sure to share the results with the member’s primary care physician. Please call the CDPHP provider service department at (518) 641-3500 if you need help identifying a member’s primary care or OB-GYN provider.
- Screen women for postpartum maternal depression, using a standardized tool such as the Edinburgh, at the mother’s and/or infant’s first medical appointment following the birth of the baby.
Important information about Medicaid reimbursement
The NYS Medicaid program will provide reimbursement, in addition to payment for an evaluation and management (E&M) service, for postpartum maternal depression screenings with a referral for diagnosis and treatment. Such screenings—using a validated screening tool—may be reimbursed up to three times within the first year of the infant’s life. The infant’s doctor can bill for this screening under the infant’s Medicaid ID, and the mother’s doctor can bill under the mother’s Medicaid ID. See NYS DOH August 2016 updates for further details.
CDPHP can help
The CDPHP behavioral health case-management team offers support to women who screen positive for, or are at risk for, postpartum depression, including those with a history of depression. Referrals for individual and group-based support are initiated when appropriate, and screenings are shared with the member’s PCP. CDPHP requires contracted behavioral health providers to coordinate treatment with PCPs and other behavioral health providers involved in a member’s care. You can refer patients to behavioral health case management services by calling 1-888-94-CDPHP (23747).