Information for Providers

EPSDT Regulations

• 450: All Provider Regulations (PDF) | RTF  

EPSDT Appendices

• Appendix W: EPSDT Services Medical Protocol and Periodicity Schedule (PDF) | RTF
  This appendix lists the services required under the Early and Periodic Screening, Diagnosis and Treatment (EPDST) Program, and the ages at which those services must be provided.
• Appendix Z: EPSDT/PPHSD Screening Services Codes (PDF) | RTF
  This appendix lists the services that are payable in addition to the EPSDT periodic visit when they are performed and interpreted in the office of the provider who furnished the visit.

EPSDT Billing Guidelines (PDF) | TEXT

EPSDT Fact Sheet

• An important message about care for children on MassHealth
  • English (PDF) | RTF
  • Spanish (PDF) | RTF
  • Brazilian Portuguese (PDF) | RTF

MassHealth Transmittal Letters and Bulletins Related to the Behavioral Health Initiative

Transmittal Letters

• TL ALL-155: Revised Regulations and Updated EPSDT and PPHSD Information (PDF) | TEXT
• TL AOH-16: Revised Service Codes and Appendix F: Behavioral-Health Screening Tool, Tobacco-Cessation Services, and HCPCS Changes (PDF) | TEXT
• TL CHC-79: New Behavioral Health Screening Tool Service Codes and Descriptions and 2008 HCPCS Coding Update (PDF) | TEXT
• 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

Training

• Training on Using Behavioral-Health Screening Tools for Children Under the Age of 21 in the Primary-Care Setting
• MassHealth Training Opportunities (Nonclinical)

Resources for Primary Care Providers

• Experienced Clinical Consultants Available to Assist in Use of Standardized Behavioral-Health Screening Tools (PDF) | TEXT

Additional Information

• Court Documents
• Contact Information