Comprehensive Perinatal Services Program (CPSP)

Grace E. Van Doren, MSN, PHN
Perinatal Services Coordinator
(805) 346-7231

The Comprehensive Perinatal Services Program (CPSP) was implemented in 1987, by the California Department of Health Services (DHS) to provide free and enhanced prenatal and postpartum care to Medi-Cal (Medicaid funded) eligible low-income women. (The DHS is now known as the California Department of Public Health (CDPH).

CPSP coordinates nutritional, health education and psychosocial (support services) assessments, interventions, education and classes with clinical obstetrical care. The local CPSP Coordinator, specifically titled Perinatal Services Coordinator (PSC), provides guidance to assist providers with the required formal application process to become CPSP certified by CDPH and with ongoing technical assistance.

What are the Goals of CPSP?

What is CPSP?

What are CPSP Services?

Who Can Become a CPSP Provider?

Who Can Deliver CPSP Services?

Models of CPSP Service Delivery

Reimbursement Schedule for Fee-for-Service Medi-Cal

• CPSP is a comprehensive program which provides a wide range of culturally appropriate 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 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.

CPSP Services include:

• Client orientation to comprehensive perinatal services
• Initial assessment, trimester reassessments, postpartum assessment, interventions, and follow-up 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

• 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

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 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

• 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.

Additional reimbursements for approved CPSP providers:

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.
  

• 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).