ForwardHealth is collecting BMI data on children enrolled in the BadgerCare Plus Standard Plan or Medicaid to gather baseline information for future policy initiatives.
ForwardHealth will reimburse an additional $10.00 to providers and clinics for reporting BMI on professional claims for routine office visits and preventive services for members two to 18 years old on the DOS.
Providers who are eligible to receive the additional reimbursement include the following:
For the additional reimbursement, Current Procedural Terminology procedure code 3008F (Body mass index, documented) is required on the claim in addition to an office visit procedure code. A $10.00 minimum is required to be billed for procedure code 3008F.
Procedure code 3008F must point to one of the following BMI diagnosis codes in the following table, as appropriate.
| Code | Description |
| V85.51 | Body Mass Index, pediatric, less than 5th percentile for age |
| V85.52 | Body Mass Index, pediatric, 5th percentile to less than 85th percentile for age |
| V85.53 | Body Mass Index, pediatric, 85th percentile to less than 95th percentile for age |
| V85.54 | Body Mass Index, pediatric, greater than or equal to 95th percentile for age |
Providers are required to maintain records that fully document the basis of charges upon which all claims for additional reimbursement payments are made.
Providers are paid $10.00 per billing provider, per child, per calendar year for reporting BMI for members in fee-for-service. Payments for reporting BMI will appear on the Remittance Advice under Explanation of Benefits 9944, "Pricing Adjustment - Incentive Pricing."