Beginning Jan. 1, 2020, the cost of each Texas Newborn Screening Program kit will increase from $55.24 to $60.58 to accommodate the inclusion of X-linked adrenoleukodystrophy (X-ALD) screening, which was added this summer.
The Texas Newborn Screening Program requires that two blood specimens be collected from each newborn: One 24 to 48 hours after birth, and a second is collected one to two weeks after birth. The state’s public health laboratory analyzes the screens.
The Texas Department of State Health Services (DSHS) laboratory screens the samples for 54 conditions. Texas hospitals and birthing facilities are required to screen for congenital hearing loss and critical congenital heart disease.
DSHS will bill health care professionals who order insurance/self-pay test kits, DSHS said. The increase will cover additional costs for laboratory and follow-up services.
The Healthcare Common Procedure Coding System (HCPCS) code for billing the newborn screening kit is S3620.
For frequently asked questions about the newborn screening program, refer to the state lab’s FAQs on specimen collection and billing. TMA members who experience billing and coding problems can submit complaints to the TMA Reimbursement Review and Resolution Service (formerly known as the Hassle Factor Log program) or contact the TMA Knowledge Center at (800) 880-7955.
Last Updated On
September 25, 2020