South Dakota Medicaid is updating the well-child check-up reimbursement rates. The new rates move the services closer to the target rate. The rate changes are applicable for dates of service of December 1, 2019 or later. The table below lists the updated rates:
| CPT Code | Description | Updated Rate |
| 99381 | New patient initial comprehensive preventative visit, infant | $103.08 |
| 99382 | New patient initial comprehensive preventative visit, age 1 through 4 | $103.08 |
| 99383 | New patient initial comprehensive preventative visit, age 5 through 11 | $103.08 |
| 99384 | New patient initial comprehensive preventative visit, age 12 through 17 | $103.08 |
| 99385 | New patient initial comprehensive preventative visit, age 18 to 39 | $103.08 |
| 99391 | Established patient initial comprehensive preventative visit, infant | $70.18 |
| 99392 | Established patient initial comprehensive preventative visit, age 1 through 4 | $70.18 |
| 99393 | Established patient initial comprehensive preventative visit, age 5 through 11 | $70.18 |
| 99394 | Established patient initial comprehensive preventative visit, age 12 through 17 | $70.18 |
| 99395 | Established patient initial comprehensive preventative visit, age 18 to 39 | $70.18 |
As a reminder well-child check-ups should be provided in accordance with the State of South Dakota’s Well-Child Services manual.
