IMPORTANT: Keep Your Provider Directory Information Current to Protect Your Network Status. Learn more

Lead Blood Tests, Developmental Screenings Required for CHIP Patients

Detecting lead poisoning and developmental issues early in children is essential so kids get timely care.

That’s why the Pennsylvania Children’s Health Insurance Program (CHIP) requires network physicians to perform lead blood tests and developmental screenings for CHIP patients of certain ages.

If you care for Highmark members with CHIP coverage, please note the following:

  • CHIP members ages 9 months to 2 years must receive at least one lead blood test.
  • CHIP members 3 years old and younger must receive annual developmental screenings to detect autism, learning disabilities, and developmental delays.

Lead testing and developmental screenings are covered benefits with no out-of-pocket costs to CHIP members and their families. And you can be reimbursed for providing both services and submitting claims to Highmark with the following procedure codes:

  • Lead blood testing – 83655
  • Developmental screening – 96110

For more information on these important services for CHIP members, see the Special eBulletin dated Nov. 9, 2018.