Accreditation of Veterinary DiagNo.ic Labs

The Circular clarifies coverage and claim rules for the PhilHealth Newborn Care Package (NCP) and the Normal Spontaneous Delivery (NSD) / Maternity Care Package (MCP) benefits.
The Circular clarifies how newborn services are provided and claimed, including requirements for newborn screening, immunization, and resuscitation documentation.
The Circular clarifies provider requirements regarding accreditation for newborn and maternity-related services.

The Newborn Care Package (NCP) may be availed by any qualified PhilHealth dependent delivered in accredited hospitals and non-hospital facilities for MCP that are certified as a newborn screening facility (Circular Nos. 24 s. 2006 and 20 s. 2007 referenced).
Qualified dependents include babies delivered via cesarean section, breech extraction, or vaginal deliveries.
An NCP claim is independent from the mother’s claim for delivery; a claim for the baby’s NCP can be filed even if the mother’s delivery is not covered by PhilHealth.
Babies of 5th and subsequent normal deliveries are qualified for NCP.
A baby’s NCP claim need not be attached to the mother’s claim for delivery.
For dependents of Employed and Individually Paying members, the only required premium is three (3) months of contribution within the immediate six (6) months prior to delivery.

Newborn screening test, BCG, and Hepatitis B immunization may be given on an outpatient basis, since normal newborn babies can be sent home as soon as possible.
The Circular treats the following as incomplete provision of services for NCP:
- Immunization done in private doctors’ clinics, and
- Newborn screening test done in another facility.
When newborn screening or immunization is incomplete as stated above, the member is advised to file directly with PhilHealth.
NCP claims must only be submitted after completion of the required services (newborn screening test, BCG and Hepatitis B immunization) if provided in an RHU (Rural Health Unit).

Resuscitation is defined as a series of actions (e.g., suctioning, administration of oxygen) to establish normal breathing, heart rate, color, tone, and response of an infant with abnormal vital signs or low Apgar score.
Normal babies require no resuscitation.
Resuscitation is required only for:
- newborns with abnormal breathing 1 minute after delivery, or
- newborns with Apgar scores below 7.
If resuscitation is performed, it must be included in Part IV c item No. 3 of PhilHealth Claim Form 2.

NCP claims are exempted from the submission of Statement of Accounts.
Since home deliveries are not covered for NSD, MCP, or Newborn Care Package, members are advised to deliver only in PhilHealth-accredited facilities.
Rural Health Units and health centers are encouraged to apply for separate accreditation as a provider of the maternity care package so they can be reimbursed expenses for MCP and NCP.

Normal Spontaneous Delivery (NSD) Package is the benefit provided by PhilHealth for coverage of normal deliveries of the first four births in accredited hospitals.
PhilHealth coverage for the first four births in accredited non-hospital facilities (e.g., lying-in clinics, birthing homes, midwife-managed clinics) is termed Maternity Care Package (MCP).
With the extended coverage of normal deliveries of the first four births, the case rate for NSD and Maternity Care Package remains the same at 4,500 pesos per case, including 2,000 pesos for professional fee in accredited hospitals.
MCP covers:
- prenatal care,
- delivery,
- post-partum care, and
- family planning.
Newborn care services previously covered by MCP are covered separately through the Newborn Care Package, consistent with PhilHealth Circular No. 20 series of 2007.

The Relative Value Unit (RVU) for treatment of incomplete abortions completed surgically (RVS Code 59812) remains 40, not 60, correcting an earlier listing under PhilHealth Circular No. 20 series of 2008.
RVS Code 59812 is titled “Treatment of incomplete abortion completed surgically” and has RVU 40.