Maternal and Infant Health Social Work Services

Maternal and infant health licensed clinical social work services provide psychosocial support, health and behavior assessment. 

They also provide intervention focused on biopsycho-social factors related to the member's perinatal health status. These services are intended for women who are at risk for various reasons.

• Drug/alcohol use
• Domestic violence
• Lack of stable food/shelter
• High-risk medical conditions
• Problems in the postpartum environment that interfere with the infant's health and bonding and/or other psychosocial concerns
• Other factors that may negatively impact the perinatal outcome

• Pregnant and/or up to 60 days postpartum SoonerCare and/or Soon-to-be-Sooners members
• Pregnant members with existing psychosocial conditions that may negatively impact the pregnancy or well-being of the newborn

• Provide short-term problem focused counseling
• Assess maternal emotional well-being
• Maternal-infant bonding and interactions
• Assist the woman in emotionally understanding and accepting the need for services or treatment
  • Ensure she follows through on all needed care
  • Follows up to see if the care she received met her needs
   

Licensed Clinical Social Workers with a current OHCA provider contract. For more information on contracting with OHCA please visit the Maternal and Infant Health Licensed Clinical Social Worker Contract. 

• 96150 – Health and behavior assessment
• 96152 – Health and behavior intervention
• 96154 – Health and behavior intervention, family with patient present
• Any combination of the three codes is acceptable if clinically appropriate.

• 32 total units per pregnancy/postpartum (unit = 15 minutes)
• Maximum of six units per day/session
• Self-referred or referred by any provider (no formal referral needed)
• Services must be provided in office, home or other confidential clinic setting
• Face-to-face and individual service
• No separate reimbursement for inpatient services
• Separate facility fee not reimbursed

All services must be reflected by documentation in the patient records. All assessment and treatment services must include the following

• Date
• Start and stop time for each timed treatment session
• Signature of service provider
• Credentials of service provider
• Documentation of the referral source
• Problem(s), goals and/or objectives identified on the treatment plan
• Methods used to address problem(s), goals and objectives
• Progress made toward goals and objectives
• Patient response to the session or intervention
• Any new problem(s), goals and/or objectives identified during the session

If you have further questions you may call the OHCA provider representative phone line: 1-877-823-4529 option 2.