Early detection of Perinatal Mood and Anxiety Disorders (PMADs) is the single most effective intervention in maternal healthcare. This reference chart provides standardized clinical cut-off scores for the Edinburgh Postnatal Depression Scale (EPDS), GAD-7, and PHQ-9, as well as emerging 2026 standards for paternal screening and anxiety subscales.
Core Screening Tool Thresholds
| Screening Tool | Score Range | Severity Classification | Recommended Action Step |
|---|---|---|---|
| EPDS Postnatal Depression | 0 - 9 | Depression Unlikely | Rescreen in 2-4 weeks if symptoms persist. |
| 10 - 12 | Possible Mild/Minor | Clinical assessment; Increase support network. | |
| 13 - 30 | Likely Major Depression | Immediate diagnostic interview & treatment plan. | |
| GAD-7 Generalized Anxiety | 0 - 4 | Minimal Anxiety | Routine monitoring. |
| 5 - 9 | Mild Anxiety | Monitor; rescreen at next clinical visit. | |
| 10 - 14 | Moderate Anxiety | Clinical evaluation; Consider CBT/Therapy. | |
| 15 - 21 | Severe Anxiety | Active treatment & psychiatric consultation. | |
| PHQ-9 | 10+ | Positive Screen | Evidence-based therapy (CBT/IPT) or meds. |
EPDS vs. PHQ-9 in Pregnancy
While both are validated for clinical depression screening, the EPDS remains the gold standard in the perinatal period specifically because it excludes somatic symptoms. Somatic symptoms on the PHQ-9 (like sleep disruptions and appetite changes) are often normal physiological changes in healthy pregnancies, which can lead to false positives.
2026 Billing Cheat Sheet
- CPT 96127: Prenatal behavioral/emotional assessment.
- CPT 96161: Postpartum screening (Health risk assessment of caregiver for the benefit of the patient).
Note: The AMA finalized unbundling of obstetric codes on Jan 1, 2026.
Interactive Score Interpreter
Select a tool and enter the total score to generate clinical recommendations.
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Specialty Subscales & Red Flags
| Metric | Threshold | Clinical Significance |
|---|---|---|
| EPDS-3A | 6+ | Specific Anxiety Subscale (Items 3, 4, 5) |
| Item 10 | > 0 | CRITICAL: Immediate suicide risk protocol |
| Paternal EPDS | 5 - 6 | Standard cut-off for identifying paternal depression |
| Remission | < 10 | Consistent score for > 14 days during treatment |
Screening Frequency (4-2-4 Model)
- 1 Month: Initial postpartum baseline (EPDS).
- 2 Months: Rescreen during primary pediatric visit.
- 4 Months: Critical window for delayed-onset PPD.
- 6 Months: Transition assessment / long-term monitoring.
2026 Clinical Practice Pearls
Race/Equity Disparity: Be aware that PPD prevalence in Black and Latina mothers can be up to 40% higher. Use culturally informed clinical interviews alongside screening tools.
Digital Monitoring: If using telehealth portals, automate alerts for any non-zero response on EPDS Item 10 or PHQ-9 Item 9 (Suicidality).
Sources: 1. ACOG Clinical Practice Guideline No. 4 (2024/2025). 2. Postpartum Support International (PSI) Clinical Standards 2026. 3. Matthey et al., Paternal Screening Standards. 4. AMA CPT 2026 Coding Manual.