Blue Shield of California Promise Health Plan has established a Maternal Mental Health Program that offers resources to Blue Shield Promise network practitioners who are providing prenatal or postpartum care to Medi-Cal or Cal MediConnect plan members.
In addition to offering support, the program requires compliance with a new California law, effective July 1, 2019. The law requires that a licensed healthcare practitioner providing prenatal or postpartum care must ensure the maternal patient is offered a screening, or is appropriately screened, for any type of mental health conditions that may be occurring.
In accordance with the law, Blue Shield Promise requires all participating network practitioners, as well as delegated entities that contract with individual practitioners, who provide prenatal or postpartum care to comply with the requirements.
Download the program description to learn more about the program and requirements:
Maternal mental health program (PDF, 93 KB)
How to screen perinatal patients for depression
Blue Shield Promise has created a simple clinical pathway that will support healthcare providers in integrating and conducting perinatal mental health screenings and linking Blue Shield Promise members to follow-up care.
Review the pathway (PDF, 28 KB)
Providers of prenatal and postpartum care for Medi-Cal members may submit claims for reimbursement twice per year for each pregnant or postpartum member: one claim when the member has been diagnosed as pregnant, and one claim during the member’s postpartum period.
To view the fee schedule, including reimbursement rates for depression screenings, please log in to Provider Connection and select the Claims tab to access the fee schedule.
Maternal mental health screening tools
All practitioners must use an evidence-based screening tool when providing a mental health screening, and the screening must be performed in conjunction with and on the same date as an outpatient visit.
Blue Shield Promise's preferred maternal mental health screening tool is the Edinburgh Perinatal Depression Scale (PDF, 137 KB). Other tools are also available:
List of approved screening tools (PDF, 81 KB)
Provider actions after completion of the maternal mental health screening
All members whose screening results indicate potential depression or other mental health conditions should be referred to Beacon Health Options ("Beacon"), our managed behavioral health organization. Follow-up for mental health services should come via Beacon's primary care physician's referral form (PDF, 107 KB).
As a Blue Shield Promise Health plan practitioner, you may consult with a Beacon psychiatrist for advice regarding the use of psychotropic medication during pregnancy for a Blue Shield Promise member. Follow these steps to contact a Beacon psychiatrist:
- Use the appropriate phone number listed above, depending on where your practice is located.
- Press “2” to bypass the phone tree.
- When speaking to a representative, explain that you are calling from a doctor's office. A licensed mental health professional will assist you in completing an internal medical doctor form and arrange a follow-up phone call with a psychiatrist.
Health education materials for perinatal members
To support pregnant and postpartum members, Blue Shield Promise has developed educational brochures on mental health, breastfeeding, and more. You may print and/or share these materials with members.