Access HealthCheck to help children receive preventive care

HealthCheck is a Wisconsin Department of Health Services (DHS) Medicaid benefit that covers most diagnostic and intervention services for beneficiaries ages 20 and younger. The goal of HealthCheck is to prevent illnesses and find and treat health issues early.

What does HealthCheck cover?

Members ages 20 and younger who are enrolled in Wisconsin Medicaid, BadgerCare Plus or ForwardHealth are automatically covered for HealthCheck services, including:

• Periodic, comprehensive screening exams, also known as well-child checks, based on the American Academy of Pediatrics periodicity schedule
• Follow-up appointments as needed
• Vision, hearing and dental services
• Immunizations 
• Lab services 
• Some prescription drugs, home health services and medical equipment when medically necessary

Developmental and autism screenings

Developmental and autism screenings are an important part of the HealthCheck benefit. Please be sure to adhere to the following guidelines for these screenings:

• Developmental screenings: Members should be screened for developmental, behavioral and social delays with a standardized global developmental screening tool by ages 1, 2 and 3
  • Use CPT® code 96110 
• Autism screenings: Members should be screened for autism by ages 18 months and 30 months
  • Use CPT code 96110 and “CG” modifier or ICD-10 code Z13.41

You can view additional screenings and resources to help you support your patient’s care. 

Submitting claims

You can submit claims for HealthCheck services using the UnitedHealthcare Provider Portal. 

Additional resources

• Procedure codes
• HealthCheck training 
• HealthCheck prior authorization requirements
• HealthCheck toolkit