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Comprehensive Perinatal Services Program
Information for Providers
The Comprehensive Perinatal Services Program (CPSP) is a Medi-Cal program that provides a model of comprehensive services for eligible low-income pregnant and parenting women. Basic to the CPSP model is the belief that pregnancy and birth outcomes improve when routine obstetric care (prenatal, delivery, and postpartum care) is integrated with specific nutrition, health education, and psychosocial services. Comprehensive services are shown to reduce the low birthweight rate by one-third and to save approximately $2 in short-term Neonatal Intensive Care Unit (NICU) costs for every $1 spent.
The goals of CPSP are to:
- Decrease the incidence of low birthweight births
- Improve the outcome of every pregnancy,
- Give every baby a healthy start in life, and
- Eliminate health disparities among racial/ethnic, gender, economic, and religious groups.
CPSP Services
CPSP services are provided by a multidisciplinary team of health care practitioners and include:
- Client orientation to comprehensive perinatal services
- Initial assessment, trimester reassessments, post-partum assessment, interventions and follow-up services in:
- Obstetrics
- Nutrition
- Health Education
- Psychosocial Services
- Individual Case Coordination
- Prenatal Vitamin/Mineral Supplements
- Referrals to Related Services
Becoming a CPSP Provider
Why become a CPSP provider?
- Fee-for-service Medi-Cal reimbursement for patients enrolled in Contra Costa Health Plan
- Ongoing consultation and technical assistance from CPSP specialists in nutrition, health education, and psychosocial consultation
- Regularly scheduled trainings for your staff
- Free copy of the CPSP Provider Handbook and Steps to Take Guidelines
- Twice-yearly forums on perinatal health issues.
Who can become a CPSP provider?
Any of the following can be a CPSP provider, as long as they have an active Medi-Cal provider number and are in good standing with their licensure board:
- Physician (obstetrician/gynecologist, family practitioner, general practitioner, or pediatrician)
- Medical Group (any of whose members is one of the above physicians)
- Certified Nurse Midwife
- Nurse Practitioner (family or pediatric)
- Preferred Provider Organization (PPO)
- Clinic (hospital, community, county)
- Alternative Birth Center
Who can deliver CPSP services?
The CPSP provider may employ or contract with any of the
following practitioners to deliver services appropriate to
their skill level:
- Physicians
- Certified Nurse Midwives
- Physician's Assistants
- Registered Nurses
- Licensed Vocational Nurses
- Social Workers
- Psychologists
- Marriage, Family and Child Counselors
- Registered Dietitians
- Health Educators
- Certified Childbirth Educators (ASPO/Lamaze, Bradley, ICEA)
- Comprehensive Perinatal Health Workers (CPHW)
See our list of current CPSP Providers.
Models of CPSP Service Delivery
- Approved CPSP providers can be found in solo practice, group practice, health departments, hospitals, community clinics, managed care plans and residency programs.
- In most cases, the entire CPSP program is offered at a single location. In other cases, obstetrical services are provided in the provider's office with other services provided elsewhere, under subcontract or by a second CPSP provider.
- Flexibility of program design and implementation allows for the use of a wide range of professional and paraprofessional personnel.
Reimbursement schedule fee-for-service Medi-Cal
Obstetrical Services
Reimbursement for obstetrical services is the same for all providers (CPSP and non-CPSP). Obstetrical services may be billed as a global charge or fee-for-service.
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services
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reimbursement
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Initial Pregnancy-Related Exam
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$ 126.31
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Antepartum Exam ($60.48/visit x 8 visits)
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$ 483.84
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Delivery (vaginal or cesarean)
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$ 544.72
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Postpartum Exam
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$ 60.48
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Subtotal
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$ 1,215.35
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Special Bonuses
Additional reimbursements for approved CPSP providers.
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Early entry into care[within 16 weeks of the last menstrual period]
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$ 56.63
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10th Antepartum visit
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$ 113.26
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Available Bonus
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$ 169.89
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For state reimbursement rates, refer to Physician Rates at Medi-Cal's site.
Support Services
- Support service reimbursement for health education, nutrition, and psychosocial services is available only to approved CPSP providers.
- Support services provided individually are reimbursed at $33.64/hour up to 23 hours. Group classes are reimbursed at $11.24/patient/hour up to 27 hours.
- A coordination fee of $85.34 is available if all three support service assessments are provided within four weeks of entry into care.
- Vitamin/mineral supplements (300-day supply) are reimbursed at $39.96 and are for use only by approved CPSP providers.
- Billing is on an itemized basis, using regular Medi-Cal billing forms. CPSP codes are available for use by approved CPSP providers.
- Total available support service reimbursement: $1,202.53
(In high-risk circumstances, additional support service reimbursement can be obtained through the treatment authorization request [TAR] process.)
Total maximum OB/CPSP reimbursement
(Before TAR): $ 2,587.77
All Medi-Cal pregnant women who are enrolled in a Medi-Cal managed care plan are entitled to receive CPSP services. Reimbursement under managed care depends on the contractual agreement between the provider and health plan or Independent Practice Association (IPA).
CPSP Application Process
- Contact the Contra Costa County CPSP Coordinator or download an application (35k PDF, 4pp.).
- The completed application will be reviewed by the local CPSP coordinator and submitted to the State Department of Health Services for final certification.
- The application approval process may take up to 60 days from the date the Coordinator receives a completed application.
CPSP Forms & Protocols
Contact CPSP
CPSP Administration
597 Center Avenue, Suite 365
Martinez, CA 94553
925-313-6254
925-313-6708 fax
Links
California CPSP
Access for Infants and Mothers (AIM)
Family PACT
Early Prenatal Care Brochure, Sutter County Public Health
English | Spanish | Punjabi
Shaken Baby Syndrome Brochure, Sutter County Public Health
English | Spanish | Punjabi
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