Maternal Dyadic Visit Incentive
Sunshine Health offers several incentive programs to support providers who promote maternal care for our members during and after pregnancy. The Maternal Dyadic Visit Incentive program supports the health of both new mothers and their children at the same time.
Incentive
The health plan offers a $50 Maternal Dyadic Visit Incentive to onsite behavioral health (BH) providers in Primary Care Physician (PCP) offices to support postpartum care.
Note: Providers with capitated agreements are not eligible for incentive programs.
What Is Dyadic Care?
Dyadic care is when providers support the health and wellbeing of both a new parent and their young child, from birth to 3 years of age, at the same time. This includes assessment, screening, counseling, and/or brief intervention provided to a parent or caregiver during, or on the same day as, the child’s pediatric well visit.
Dyadic care is important because when a parent is healthy and supported, they are better able to meet the needs of their young child. By addressing the well-being of both the parent and child together, dyadic care helps strengthen the early relationship, promote secure attachment, and support the child’s emotional regulation, overall health, and well-being.
Dyadic care is increasingly recognized as a promising best practice for improving maternal mental health by addressing postpartum concerns, including depression, that can affect the mother-infant relationship.
How Does it Work?
In the pediatric setting, providers screen the parent of children ages 3 years and under to identify and address family risk factors of the adult that could impact the child or parent-child relationship. When a screen is positive, or when requested by the caregiver, a behavioral health provider may offer a brief intervention during or on the same day as the well-child visit.
Providers are eligible for the incentive if they offer on-site counseling or a brief intervention during or immediately after the parent completes their screening during the child’s well visit.
Who Can Provide Dyadic Services?
- Licensed clinical social workers
- Licensed professional clinical counselors
- Licensed marriage and family therapists
- Licensed psychologists
- Psychiatric physician assistants
- Psychiatric nurse practitioners
- Master-level behavioral health provider rendering the service under licensed independent supervising clinicians
Billing Guidance for Dyadic Care
Service | Code | Billing Guidance |
|---|---|---|
Caregiver screening | 96161 | Billed by the medical pediatric provider as part of the well-child visit. |
Caregiver screening with positive family risk score | 96161XU | Billed by the medical pediatric provider when screening indicates family risk. |
Dyadic Behavioral Health (DBH) well-child visit | H1101 | Billed by the behavioral health provider when the dyad is seen on the same day by both providers. |
*Services should be rendered on the same day.
Note: Providers must have an updated W-9 tax form on file with the health plan to ensure no disruptions in payment. To update your W-9, utilize the Provider Demographics Updates tool.
Questions?
Contact your Sunshine Health Provider Engagement Account Manager (PEAM) or call Provider Services at 1-844-477-8313.