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BCBS Reimbursement for Well Child Care - Coverage Frequency and Limitations

Well-child care refers to physician-provided preventive health care services for children. The well-child benefit applies to an insured dependent child under Blue Cross and Blue Shield of Florida BlueOptions, BlueChoice or Traditional products. Well-child services include:

• The first newborn examination in the hospital by a physician other than the delivering obstetrician or anesthesiologist.

• Periodic examinations to monitor the normal growth and development of a child.

• Specified immunizations (see chart)

• Specified laboratory tests (see chart)

Well-child services are not subject to a calendar-year deductible and are reimbursed at the contracted percentage of the allowed amount. The above chart outlines the appropriate CPT codes to use when billing for well-child care services and the number allowed at each age interval.

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