Autism Screening and Services
Autism Spectrum Disorder (ASD) Screening and Referral Process
Accurate and early diagnosis of ASD is critical in ensuring appropriate intervention and positive outcomes. The Michigan Department of Health and Human Services (MDHHS) process for the identification of ASD in Medicaid and MIChild children 18 through 5 years of age requires screening by the primary care provider (PCP) with further diagnostic evaluations through the Pre-paid Inpatient Health Plan (PIHP). The PIHP for Upper Peninsula Health Plan members is NorthCare Network, which provides services in all 15 counties in the Upper Peninsula.
Screening for ASD will be performed by the child’s PCP utilizing a validated screening tool administered as part of a well exam at 18 and 24 months of age, if needed at well exams as early as 12 months of age, and after 24 months of age when children have not been previously screened.
The Modified Checklist for Autism in Toddlers (M-CHAT) is a validated screening tool for toddlers 16 months through 30 months of age. The Social Communication Questionnaire (SCQ) may be utilized for children older than 4 years of age. The best applicable of the two tools should be administered for children 30 months through 4 years (M-CHAT if mental age is less than 2 years of age; SCQ if mental age is greater than 2 years of age).
Providers may bill for the administration of an autism screen by using CPT code 96110 with a U5 modifier.
To view the M-CHAT autism screening tool with instructions, click here.
In the Upper Peninsula, the PCP who screened the child and determined a referral for further evaluation is necessary will contact NorthCare Network using the following process:
- PCP will fax the M-CHAT/SCQ results along with any additional supporting documentation to the NorthCare Network central fax line: 1-906-225-7352
- NorthCare Network will contact the parent/guardian to arrange a local follow-up appointment for a diagnostic evaluation
NorthCare Network Access Unit Contact Information
Provider Resources (American Academy of Pediatrics)
Page Last Updated: 09/26/2018