- 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.
| Services |
Reimbursement
|
| Initial Pregnancy-Related Exam |
$ 126.31
|
|
Antepartum Exam
($60.48/visit x 8 visits)
|
$ 483.84
|
| Delivery (vaginal or cesarean) |
$ 544.72
|
| Postpartum Exam |
$ 60.48
|
|
| Subtotal |
$ 1,215.35
|
Special Bonuses
Additional reimbursements for approved
CPSP providers:
Early entry into care
[within 16 weeks of the last
menstrual period (LMP)] |
$ 56.63
|
|
10th Antepartum visit
|
$ 113.26
|
|
| Available Bonus |
$ 169.89
|
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.

|