The MassHealth Pharmacy Program created the Pediatric Behavioral Health Medication Initiative to ensure safe and effective prescribing of behavioral health medications for members covered by MassHealth who are less than 18 years of age. Please see the links below for detailed information regarding this initiative.
PBHMI Letter to Prescribers
This letter to prescribers describes the PBHMI and goals of the initiative.
PBHMI Clinical Document
This PBHMI clinical document provides a general overview of the initiative and the affected medication classes.
PBHMI Therapeutic Class Table
This therapeutic class table displays the medications affected by the PBHMI and the MassHealth requirements for prior authorization.
PBHMI Prior Authorization (PA) Form for Pharmacy Services
The PBHMI PA form was created to assist prescribers with requests submitted to the MassHealth Drug Utilization Review (DUR) Program.
This Q&A answers frequently asked questions regarding the PBHMI.
For Pharmacists and Prescribers
If you have questions about a specific patient or claim affected by the MassHealth Pediatric Behavioral Health Medication Initiative (PBHMI), please contact the Drug Utilization Review Program at 1-800-745-7318.
If you have comments about the PBHMI, contact the Drug Utilization Review Program at 1-800-745-7318 or e-mail the MassHealth Pharmacy Program at email@example.com. Please include your name, title, phone number, and fax number.
Please note: MassHealth will not answer all e-mails but will use this feedback for further improvements to the Pediatric Behavioral Health Medication Initiative. This mailbox is dedicated to questions or comments about the MassHealth Pediatric Behavioral Health Medication Initiative only.
For MassHealth Members
If you have questions about the MassHealth Pediatric Behavioral Health Medication Initiative, please call MassHealth Customer Services at 1-800-841-2900 (TTY: 1-800-497-4648).