MassHealth requires PCPs to offer to use a standardized behavioral-health screening tool from the list in Appendix W at every EPSDT/PPHSD visit. PCPs choose a clinically appropriate tool from the list, based on the age of the child.
What is a PCP?
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.
Physician Assistants and Nonindependent Nurse Practitioners and 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.