Postpartum Depression Screening

Postpartum depression (PPD) is a common but often underdiagnosed condition that can significantly affect the well-being of new mothers. Early identification through appropriate screening tools like the Edinburgh Postnatal Depression Scale (EPDS) and PHQ-9 is essential for timely intervention. While screening is important, many healthcare providers wonder about the billing aspect:

Is postpartum depression screening billed separately or included in the OB package?

If the physician is delivering care under the global obstetrical package and billing a global code, most payers may consider postpartum depression screening to be included in that bundled service. This is especially the case when screening is routinely performed on all patients. In such scenarios, separate reimbursement may not be provided. However, some payers may reimburse the service independently; therefore, providers should confirm their billing policies with each payer.

When Depression Is Diagnosed?

If the screening results in a diagnosis of depression, the service may be billed separately, as the global obstetric package only includes care for uncomplicated antepartum, delivery, and postpartum periods. It is important to note that specific payers may only reimburse psychologists or psychiatrists for the management of depression. Providers must be aware of payer-specific limitations and requirements.

ICD-10 Code Updates

Updates were made to ICD-10 category F53. It now includes:

• F53.0 Postpartum depression
• F53.1 Puerperal psychosis

CPT Coding for Screening Tools

For EPDS (Edinburgh Postnatal Depression Scale)

Use CPT code 96160, which covers the administration of a patient-focused health risk assessment instrument, including scoring and documentation.

For PHQ-9 Depression Screening

Payers may differ in preferences. Some accept the evaluation and management code with modifier 25 billed in conjunction with 96160 or 96161. In contrast, others recommend using CPT 96127, which is defined as a brief emotional or behavioural assessment, including scoring and documentation, using a standardized instrument.

Automated Psychological Testing

CPT code 96146 was introduced for automated psychological or neuropsychological testing conducted through an electronic platform, with automated scoring and reporting. This code should only be reported when the test is administered electronically without the involvement of a physician or other clinical staff. If a provider or technician is involved, use other codes such as 96127, 96136, 96137, 96138, or 96139 as appropriate.

Streamlined OB Screening Billing with BillingFreedom

Accurately billing for postpartum depression screening within OB care requires a deep understanding of payer-specific rules and global obstetrical package limitations. BillingFreedom ensures that screenings, such as the Edinburgh Postnatal Depression Scale (EPDS) and PHQ-9, are reported correctly using the appropriate CPT codes, including 96160, 96127, or 96146, based on payer guidance and the method of administration.

Our OB medical billing specialists help providers distinguish when depression screenings qualify for separate reimbursement, especially when a diagnosis is made or when documentation supports standalone billing. We manage modifier usage, ICD-10 updates, and payer compliance to minimize denials and maximize revenue. With BillingFreedom, OBGYN practices gain a trusted partner in achieving billing accuracy, faster reimbursements, and full revenue integrity for both routine and mental health-related postpartum care.

For more details about our exceptional OB/GYN billing services, please don't hesitate to email us at info@billingfreedom.com or call us at +1 (855) 415-3472. 

Your financial tranquility is our priority!