FAQ Directory

Practices need to identify behavioral health-related criteria pertinent to their specific patient population such as a behavioral health diagnosis, substance use, a positive screening result from a standardized behavioral health screen, or psychiatric hospitalizations. If the practice feels that patients with temper tantrums is an identifier for patients in need of care management, the practice can use that defining criteria.

This applies to the following Programs and Years:

This applies to the following Programs and Years:

Practices can use two methods to collect language need information:

1. Collect data from all patients and their families to create a report showing language needs.

2. Obtain data from an external source (e.g., data about the local community or its patient population).

Patients who do not speak English and patients from racial/ethnic minority groups may be less inclined to provide this information. Care should be taken to request the information using methods that respect multi-cultural differences.

This applies to the following Programs and Years:

 –https://www.aap.org/en-us/professional-resources/practice-support/Telephone-Care/Pages/Telephone-Care.aspx 

This applies to the following Programs and Years:

Yes, unhealthy behaviors can be the result of parent behavior but ultimately, we're looking for the unhealthy behaviors demonstrated by the patient (child). Secondhand smoke may be a direct example of a parent’s behavior affecting the child’s health and poor oral hygiene may be a child’s unhealthy behavior, but could result from lack of parental oversight or health literacy.

This applies to the following Programs and Years:

− Shared Decision-Making in Pediatrics: A National Perspective Pediatrics 2010;126;306: 
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373306/ 

This applies to the following Programs and Years:

NCQA is not prescriptive regarding which depression screening tool is used as long as it’s a standardized tool. Some depression screening tool examples that would be appropriate for adolescents include but are not limited to PHQ2, PHQ9, PHQ-A, PSC, PSC-Y, RAAPS, or HEADSS. 

This applies to the following Programs and Years:

A reminder to schedule a follow-up visit related to an infection (e.g., otitis media, pharyngitis, urinary tract infection) or an injury (e.g., fracture, burn or cut requiring stitches) applies as an acute care service. 

This applies to the following Programs and Years:

No, just having extra appointments based on the season would not meet the intent. The practice may have more same day appointments offered during these high-volume time periods but some same day appointments should be provided daily throughout the year.

This applies to the following Programs and Years:

Pediatric practices may want to look into quality improvement projects offered by state AAP chapters and national AAP. The AAP QI Webpage lists a variety of opportunities: https://www.aap.org/en-us/professional-resources/quality-improvement/Pages/ActivityList.aspx

This applies to the following Programs and Years:

Pediatric examples for behavioral health conditions would also include but are not limited to autism or ASD, downs syndrome, Asperger's, cerebral palsy, or developmental delay.

This applies to the following Programs and Years:

No. Practices may not use the same immunization for two age groups, and must identify two different immunizations for this criterion.

This applies to the following Programs and Years: