Using Enhanced Rates to Support and Financially Maintain a HealthySteps Program at an Academic Primary Care Practice

HealthySteps is an evidence-based, interdisciplinary program that promotes positive parenting as well as the health and well-being of infants and toddlers, specifically in underserved communities. In Maryland, Medicaid provides enhanced reimbursement for recognized HealthySteps services under code H0025. This quality improvement initiative evaluated whether implementing the use of H0025 could support the financial sustainability of HealthySteps in an academic, hospital-based primary care practice, aiming to increase H0025 utilization from 0% to 70% within 12 months. Targeted clinician education and electronic medical record-based interventions were implemented using quality improvement methods. During the study period, 73% of eligible encounters were billed using H0025, with utilization rising to 88% by the end of the intervention. We conclude that enhanced reimbursement through H0025 can partially support a HealthySteps program.