Federal Employee Program (FEP) Joins the CenteringPregnancy Initiative

Jan. 17, 2023

As of Jan. 1, 2023, BlueCross BlueShield of South Carolina’s Federal Employee Program (FEP) plans began participating in the CenteringPregnancy initiative. CenteringPregnancy is a prenatal care group program which brings women with similar due dates together in the comfort of a group setting instead of being in an exam room.

In CenteringPregnancy, after a woman has her initial obstetric appointment and exam, she is placed in a group with eight to 12 other women who have due dates in the same month. They receive all their prenatal care visits together in 10 sessions of two hours each throughout their second and third trimesters. A health care provider facilitates the groups, carrying out all the medical care the women would routinely receive per the prenatal care guidelines from the American College of Obstetrics and Gynecology.

Provider specialties included for reimbursement are obstetrics and gynecology (OB/GYN), family practice and certified nurse midwives.

Billing and reimbursement

99078

  • Include the TH modifier
  • File in addition to evaluation and management (E&M) codes for the same date of service
  • File with specific pregnancy-related diagnosis code
  • Pays separately from global maternity
  • Reimbursed at $30 per member, per session (maximum of 10)

0502F

  • Retention incentive indicating continued participation
  • File in addition to procedure code 99078 on the fifth visit
  • File with specific pregnancy-related diagnosis code
  • Payable once per benefit period
  • Reimbursed at $175 once per member

For questions on this bulletin, please contact Provider Education at 803-264-4730 or Provider.Education@bcbssc.com.

The Centering Healthcare Institute is an independent company that provides access to the CenteringPregnancy program on behalf of BlueCross BlueShield of South Carolina.

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