• To decrease the incidence of low birthweight in infants
• To improve the outcome of every pregnancy
• To give every baby a healthy start in life
• To lower health care costs by preventing catastrophic and chronic
  illness in infants and children

What is the CPSP Program?

• CPSP is a comprehensive program which provides a wide range of culturally competent services to pregnant women from conception through 60 days postpartum.
• The program was developed from the OB Access Project, a successful perinatal demonstration project for 7,000 low-income women that operated from 1979 to 1982 in 13 California counties.

Comprehensive services were shown to reduce the low birthweight rate by one-third and to save approximately $2 in short-term Neonatal Intensive Care Unit (NICU) costs for every $1 spent. Because of these positive results, CPSP was legislated in 1984 and included as part of the Medi-Cal program in 1987.

What are the CPSP services?

CPSP Services include:

• Client orientation to comprehensive perinatal services
• Initial assessment, trimester reassessments, post-partum assessment, interventions and follow-up services in:
  • Obstetrics
  • Nutrition
  • Health Education
  • Psychosocial Services
• Individual Case Coordination
• Prenatal Vitamin/Mineral Supplements
• Linkages with Women, Infants and Children
  Supplemental Nutrition Program (WIC), genetic
  screening, dental care, family planning and
  pediatric care

Who can become a CPSP provider?

Any of the following can be a CPSP provider, as long as they have an active Medi-Cal provider number, and are in good standing with their licensure board:

• Physician (obstetrician/gynecologist, family practitioner, general practitioner, or pediatrician)
• Medical Group (any of whose members is one of the above physicians)
• Certified Nurse Midwife
• Nurse Practitioner (family or pediatric)
• Preferred Provider Organization (PPO)
• Clinic (hospital, community, county)
• Alternative Birth Center

Who can deliver CPSP services?

The CPSP provider may employ or contract with any of the
following practitioners to deliver services appropriate to
their skill level:

• Physicians
• Certified Nurse Midwives
• Physician's Assistants
• Registered Nurses
• Licensed Vocational Nurses
• Social Workers
• Psychologists
• Marriage, Family and Child Counselors
• Registered Dietitians
• Health Educators
• Certified Childbirth Educators (ASPO/Lamaze, Bradley, ICEA)
• Comprehensive Perinatal Health Workers (CPHW)
  • At least 18 years old
  • High School Diploma
  • Minimum one year paid perinatal experience

Models of CPSP service delivery

• Approved CPSP providers can be found in solo practice, group practice, health departments, hospitals, community clinics, managed care plans and residency programs.
• In most cases, the entire CPSP program is offered within a single location. In others, 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.

Reimbursement schedule fee-for-service Medi-Cal

Obstetrical Services

Reimbursement for obstetrical services is the same for all providers (CPSP and non-CPSP). Obstetrical services may be billed as a global charge or fee-for-service.

Special Bonuses

Additional reimbursements for approved CPSP providers:

Reimbursement for Santa Barbara Regional Health Authority Medi-Cal
www.sbrha.org
For state rates, click on Physician Rates at www.medi-cal.ca.gov.

Support Services

• Support service reimbursement for health education, nutrition, and psychosocial services is available only to approved CPSP providers.
• Support services provided individually are reimbursed at $33.64/hour up to 23 hours. Group classes are reimbursed at $11.24/patient/hour up to 27 hours.
• A coordination fee of $85.34 is available if all three support service assessments are provided within four weeks of entry into care.
• Vitamin/mineral supplements (300-day supply) are reimbursed at $39.96 and are for use only by approved CPSP providers.
• Billing is on an itemized basis, using regular Medi-Cal billing forms. CPSP codes are available for use by approved CPSP providers.
• Total available support service reimbursement: $1,202.53*
  * In high-risk circumstances, additional support service reimbursement can be obtained through the treatment authorization request (TAR) process.

Total maximum OB/CPSP reimbursement
(Before TAR): $ 2,587.77

• All Medi-Cal pregnant women who are enrolled in a Medi-Cal managed care plan are entitled to receive CPSP services. Reimbursement under managed care depends on the contractual agreement between the provider and health plan or Independent Practice Association (IPA).

CPSP Application Process

• Contact the CPSP coordinator at your local health
  department for an application.
• The completed application will be reviewed by the local CPSP coordinator and submitted to the State Department of Health Services for final certification.
• The application approval process may take up to 60 days from the date the local coordinator receives a completed application.