The Comprehensive Perinatal Services Program

CPSP

Insert name of PSC

Insert date

What is the CPSP?

•The CPSP provides enhanced perinatal services for Medi-Cal eligible women from the date of conception through the end of the second month after delivery

•The CPSP has been shown to improve birth outcomes

•Medi-Cal Managed Care plans are required to provide access to CPSP services for all Medi-Cal eligible enrollees

Goals of the CPSP

Decrease and maintain the decreased level of perinatal, maternal and infant mortality and morbidity

Support methods of providing comprehensive prenatal care that prevent prematurity and the incidence of low birth weight infants

http://www.cdph.ca.gov/services/funding/mcah/Documents/MO-MCAH-MCAHPP-2012-13.pdf

Why be a CPSP Provider?

•Better patient outcomes

•CPSP offers higher reimbursement

•More staffing flexibility

Basic OB vs. CPSP Reimbursement

Service Basic OB CPSP

Initial Exam 126.31 126.31

Antepartum Exam 483.84 483.84

Delivery 544.72 544.72

Postpartum Exam 60.48 60.48

Early entry into care 0 56.63*

Vitamins 0 30.00

Case Coordination 0 85.34*

10th antepartum visit 0 113.26*

Support Services (max) 0 1077.20

Total potential payments (before TAR) $1215.35 $2577.78

* Not available to FQHCs

CPSP Flow Sheet and Billing Summary

CPSP Documentation Requirements and Forms

• Client Orientation• Initial Assessments• Individualized Care Plans• Reassessments (second, third trimester and

postpartum)• Referrals

All recommended forms are located here:

http://www.cdph.ca.gov/programs/CPSP/Pages/LHJPerinatalServicesCoordinatorInformation.aspx

• Orientation

• Case Coordination

• OB

• Psychosocial

• Health Education

• Nutrition

• Perinatal Education individual groups

• Vitamin/mineral supplements

• Initial assessments• Trimester reassessments• Postpartum assessments• Intervention/follow-up

CPSP Services

CPSP Model of Care

• Client centered• Strength-based• Multi-disciplinary• Site specific protocols• Culturally sensitive• Community referrals• Voluntary participation

Who can Become a CPSP Provider?

Any of the following can become a CPSP provider, if they have an active National Provider Identifier (NPI) number and are an active Medi-Cal provider in good standing with Medi-Cal and their licensing board:– Physicians, including general practitioners, family practice

physicians, pediatricians, or obstetrician-gynecologists

– Certified Nurse Midwives (CNMs)

– Medical Groups

– Clinics

– PPOs

http://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/part2/pregcom_m00o03.doc

Who can Deliver CPSP Services?

All CPSP Providers and the following CPSP Practitioners may deliver CPSP services under the supervision of a physician and as permitted by their Scope of Practice, if licensed.

Registered Nurses Nurse Practitioners Physician Assistants Social Workers Health Educators Childbirth Educators Registered Dieticians Comprehensive Perinatal Health Workers (CPHW) who are at least

18 years old, have a High School Diploma, and have a minimum one year paid perinatal experience.

http://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/part2/pregcom_m00o03.doc

Models of CPSP Service Delivery

• Approved CPSP providers can be found in solo practice, group practice, health departments, hospitals, community clinics, managed care plans, Federally Qualified Health Center (FQHCs), Indian Health Services (IHS), Rural Health Clinics (RHCs), and residency programs

• In some cases, obstetrical services are provided in the provider’s office with other services provided elsewhere, under subcontract, or by a second CPSP provider

• Flexibility of program design and implementation allows for the use of a wide range of professional and paraprofessional personnel

Protocols for CPSP Services & Supervision

22 CCR 51179.9 defines “Protocol” as "written procedures for providing psychosocial, nutrition, and health education services and related case coordination.”

22 CCR 51179.5 defines “Personal supervision” as "evaluation, in accordance with protocols, by a licensed physician, of services performed by others through direct communication, either in person or through electronic means.”http://www.cdph.ca.gov/services/funding/mcah/Documents/MO-MCAH-MCAHPP-2012-13.pdf

http://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/part2/pregcom_m00o03.doc

The CPSP Application Process

• Your CPSP Perinatal Services Coordinator (PSC) can assist you with your application

• The PSC will review the completed application and submit it to the California Department of Public Health (CDPH/MCAH) for final approval

• The application approval process may take up to 60 days from the date that CDPH/MCAH receives a completed application

• http://www.cdph.ca.gov/programs/CPSP/Pages/ApplicationforCertificationasaCPSPProvider.aspx

How does the CPSP work in FQHCs & RHCs?

• TARs (Treatment Authorization Request) are not used in FQHCs or RHCs however, chart documentation for additional CPSP services must demonstrate the same justification necessary to obtain a TAR.

• FQHCs and RHCs should bill the MCMC plan first for services to MCMC clients and should contact the FI for information regarding any additional payments for which they may be eligible

• CPSP visits in these health care delivery settings are paid at a flat fee per visit, for on-site and off-site services, as defined in their prospective payment system

Electronic Health Record (EHR)

• EHRs should facilitate the CPSP work flow in each provider office

• Each PSC and Provider should evaluate the content and functionality of the EHR system

• The PSC will review the EHR content using an approved set of CPSP forms as a guide to assure that required elements of State recommended prenatal and postpartum assessment, reassessment, and intervention are included

http://www.cdph.ca.gov/services/funding/mcah/Documents/MO-MCAH-MCAHPP-2012-13.pdf

Resources:• CPSP Website

http://www.cdph.ca.gov/programs/CPSP/Pages/default.aspx

• Provider Handbook

http://www.cdph.ca.gov/programs/CPSP/Documents/MO-CPSP-ProviderHandbook.pdf

• Steps To Take

http://www.cdph.ca.gov/programs/CPSP/Documents/MO-CPSP-StepsToTake.pdf

• Medi-Cal Website

http://www.dhcs.ca.gov/Pages/default.aspx

• PSCs Directory

CPSP Perinatal Services Coordinators

Honorable Edmund G. Brown Jr. Governor

State of California

2014California Department of Public Health

Maternal and Child Adolescent Health Program1615 Capitol Avenue, MS 8306

Sacramento, California 95899-7420

Diana DooleySecretary

California Health & Human

Services Agency

Ron Chapman, MD, MPH

DirectorCalifornia

Department Of Public Health

Thank you!

Questions??