2023-16: Mid-year Quality Incentive Adjustments Beginning on August 1, 2023
Date: 06/29/23
Beginning August 1, 2023, our Medicaid "Per Click" quality incentives will be adjusted for all in-network providers as noted below. This adjustment is based on updated incentive guidance from LDH and feedback from our provider network.
The per code measurements will continue to be based on a calendar year reporting period.
Detailed reports about your quality bonus payment, as well as other quality measures, are available on the secure provider portal.
2023 Incentive Measures | Procedure Code | Amount |
Cervical Cancer Screening (CCS) | 87624, 87625, 88141, 88142, 88143, 88147, 88148, 88150, 88152, 88164, 88174, 88175 | $20.00 |
Child and Adolescent Well-Care Visits (WCV) | 99381, 99382, 99383, 99384, 99385, 99391, 99392, 99393, 99394, 99395, 99461, G0438, G0439, S0610, S0612 | $40.00 |
Colorectal Cancer Screening (COL) | 4438944392, 44394, 44404, 44405, 45330, 45331, 45332, 45333, 45334, 45335, 45337, 45338, 45340, 45341, 45342, 45349, 45350, 45378, 45379, 45380, 45381, 45382, 45384, 45385, 45386, 45388, 45389, 45390, 45391, 45392, 45393, 45398, 74261, 74262, 74263, 81528, 82270, 82274 | $50.00 |
Controlling High Blood Pressure (CBP) | 3074F, 3075F, 3079F | $10.00 |
Developmental Behavioral Screening (EPSDT) | 96110 | $10.00 |
Topical Fluoride Varnish (TFV) | 99188 | $10.00 |
Follow-up After Emergency Department Visit for Mental Illness (FUM) | 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90847, 90849, 90853, 90875, 98960, 98961, 98967, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99241, 99242, 99243, 99244, 99245, 99251, 99252, 99253, 99254, 99255, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99441, 99442, 99443, 99483, 99495, 99496, 99510 | $25.00 |
Follow-up After Emergency Department Visit for Substance Abuse (FUA) | 98960, 98961, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99408 | $25.00 |
Follow-up After Hospitalization for Mental Illness (FUH) | 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90847, 90849, 90853, 90875, 98960, 98961, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99221, 99222, 99223, 99231, 99233, 99234, 99238, 99239, 99241, 99242, 99243, 99244, 99245, 99251, 99252, 99253, 99254, 99255, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99383, 99384, 99385, 99386, 99387, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, | $25.00 |
Hemoglobin A1c Control for Patients with Diabetes (HBD) | 3044F, 3051F | $10.00 |
Hepatitis C Virus (HCV) Testing | 86803, 86804, 87520, 87521, 87522 | $5.00 |
Human Papillomavirus (HPV) Vaccine | 90649, 90650, 90651 | $15.00 |
Influenza Vaccine (FLU) up to 21 years old | 90655, 90657, 90660, 90661, 90662, 90672, 90674, 90685, 90686, 90687, 90688, G0008 | $20.00 |
Post-Partum Care (PPC) | 0503F, 59430 | $50.00 |
Syphilis (SYPH) Testing | 86592 | $10.00 |
Human Immunodeficiency Virus (HIV) Testing | 86703 | $10.00 |
Hepatitis BsAg (HBV) Testing | 87340 | $10.00 |
Chlamydia (CT) Testing | 87491 | $10.00 |
Gonorrhea (GC) Testing | 87591 | $10.00 |
Notification of Pregnancy (NOP) | $75.00 |
As a valued provider in our network, you do not need to do anything to participate in this incentive program. Simply provide the appropriate preventive care and screenings, submit claims, and be rewarded for helping improve Louisiana's health.
If you have any questions, please don’t hesitate to contact your dedicated Provider Engagement Administrator or call Provider Services at 1-866-595-8133.