Early Periodic Screening Diagnosis and Treatment (EPSDT) and Preventive Pediatric Health Care Screening and Diagnosis Services (PPHSD) Information and Resources

• EPSDT/PPHSD Regulations
  • 450: All Provider Regulations (PDF)  file size 1MB The regulations governing the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services and Preventive Pediatric Health Care Screening and Diagnosis (PPHSD) appear in 130 CMR 450.140 through 150.

• EPSDT/PPHSD Appendices
  • Appendix W: EPSDT Services Medical and Dental Protocol and Periodicity Schedule (PDF) 
    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) 
    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) 
    These Guidelines provide information to physicians and mid-level providers who bill MassHealth EPSDT and PPHSD services.

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This information is provided by MassHealth.