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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

Who Qualifies for Services?

  • 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

What Services do Maternal and Infant Social Workers (MIH) Provide?

  • 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

Who qualifies to provide services?

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. 

What procedures are covered under the MIH?

  • 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.

What are the service limitations and conditions?

  • 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

What documentation must be maintained by the social worker?

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.


Last Modified on Dec 02, 2020
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