Information for Providers
Child and Adolescent Needs and Strengths (CANS)
- Information and materials related to the administration of the Massachusetts CANS tools.
EPSDT/PPHSD Regulations
- 450: All Provider Regulations (PDF) | RTF The regulations governing the Early and Periodic Screening, Diagnosis and Treatment Services (EPSDT) and Preventive Pediatric Healthcare Screening and Diagnosis (PPHSD) programs appear in 130 CMR 450.140 through 150.
EPSDT/PPHSD Appendices
- Appendix W: EPSDT Services Medical Protocol and Periodicity Schedule (PDF) | RTF
This appendix lists the ages for well-child EPSDT and PPHSD periodic visits and the services required at each visit. - Appendix Z: EPSDT/PPHSD Screening Services Codes (PDF) | RTF
This appendix lists the services that are payable in addition to the EPSDT or PPHSD periodic visit when they are performed and interpreted in the office of the provider who furnished the visit and the codes to claim those services.
EPSDT/PPHSD Billing Guides
- EPSDT/PPHSD Billing Guidelines (PDF) | TEXT
These Guidelines provide information to physicians and mid-level providers who bill MassHealth on a fee-for-service basis for EPSDT and PPHSD services.
EPSDT/PPHSD Fact Sheet
- An important message for school nurses, child-care providers, school districts, Head Start programs, Early Intervention Program providers, and other providers and clinicians who come into contact with children under the age of 21 about EPSDT and PPHSD services and behavioral health services generally available through MassHealth for children under the age of 21.
MassHealth Transmittal Letters and Bulletins Related to the Behavioral Health Initiative
Transmittal Letters
- ALL-171: Revised Regulations and Updated EPSDT Information (PDF) | TEXT
- All Provider Transmittal Letter 155 (TL ALL-155): Revised Regulations and Updated EPSDT and PPHSD Information (PDF) | TEXT
- Acute Outpatient Hospital Transmittal Letter (TL AOH-17): Revised Subchapter 6 and Appendix F for 2008 HCPCS (PDF) | TEXT
- Acute Outpatient Hospital Transmittal Letter 16 (TL AOH-16): Revised Service Codes and Appendix F: Behavioral-Health Screening Tool, Tobacco-Cessation Services, and HCPCS Changes (PDF) | TEXT
- Community Health Center Transmittal Letter (TL CHC-80): 2008 HCPCS (PDF) | TEXT
- Community Health Center Transmittal Letter (TL CHC-79): New Behavioral Health Screening Tool Service Codes and Descriptions and 2008 HCPCS Coding Update (PDF) | TEXT
- Physician Transmittal Letter (TL PHY-121): Physician Manual (2008 HCPCS) (PDF) | TEXT
- Physician Transmittal Letter (TL PHY-120): New Behavioral Health Screening Fee and 2008 HCPCS Coding Update (PDF) | TEXT
Bulletins
- Chronic Disease and Rehabilitation Outpatient Hospital Bulletin 3: New Service Code to Claim and Report Behavioral Health (Mental Health and Substance Abuse) Screenings for MassHealth Members Under the Age of 21 Years (PDF) | TEXT
Resources for Primary Care Providers
- Resources to Assist with Clinical Questions Arising from a Behavioral Health Screen (PDF) | TEXT
Contact information for the Massachusetts Child Psychiatry Access Project (MCPAP), is a resource available to assist you with all clinical questions that might arise when you perform a screen where a behavioral-health need is identified.
Additional Information
This information is provided by MassHealth.