Prenatal Psychosocial Assessment

Reimbursement is available for initial assessment of pregnant SoonerCare Choice and Traditional members by qualified SoonerCare practitioners of prenatal care services. 

The following two specific forms must be completed and included together in the prenatal record to receive reimbursement.  

The ACOG form can be purchased on the ACOG Web site and the OHCA Prenatal Psychosocial Assessment form is available on its Web site. Providers may bill for this service with HCPC code H1000 with a limit of one assessment per pregnancy. Members that choose to change providers during their pregnancy are limited to two assessments per pregnancy (one per provider).


The OHCA Prenatal Psychosocial Assessment form is designed to provide a comprehensive, standardized format for the assessment and documentation of psychosocial issues in pregnant patients. It is composed of questions addressing various social and other concerns that may affect the patient’s health and pregnancy. The form is intended to assist practitioners in identifying patient needs in order to promote healthy outcomes for both the mother and the baby. Due to the sensitive nature of the information requested in the psychosocial assessment, it is recommended that practitioners make every effort to allow patients to complete the form in private.


Practitioners can use these two forms together as a comprehensive assessment tool to help determine necessary treatment and intervention services i.e., referrals to a social worker, MFM, genetic counselor, or other professional(s).
The Oklahoma Areawide Services Information System (OASIS) Web site provides information on local and statewide services. It may be a helpful resource in assisting your patients with access to services and treatment for various psychosocial concerns.