MassHealth requires PCPs to offer to use a standardized behavioral-health screening tool from the list in Appendix W (PDF) at every EPSDT/PPHSD visit. PCPs choose a clinically appropriate tool from the list, based on the age of the child.
PCPs include the following, whether they practice in an individual or group practice, in the outpatient department of a hospital (acute or chronic disease and rehabilitation hospital), or in a community health center.
- physicians: pediatricians, family practitioners, internists, OB/GYNs, and general practitioners;
- independent nurse practitioners; and
- independent nurse midwives.
Nonindependent nurse practitioners, nonindependent nurse midwives, and physician assistants are permitted to conduct screens when they are under a physician's supervision. When they provide screening visits according to Appendix W (EPSDT Periodicity Schedule), the visits are payable to the physician under whose supervision they work.
If a condition is discovered that requires further assessment, diagnosis, or treatment during a visit, the PCP must either:
- provide the necessary follow-up services; or
- refer the member to a specialist.
It is important to note that screening is voluntary; while it must be offered, the family is free to refuse the screening.
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