Behavioral Health and Developmental Screening in Primary Care

Each preventive visit from newborn to age 21 should include a psychosocial and behavioral health assessment, using the clinically and age-appropriate screening tools listed in the Instruments for Recommended Universal Screening at Specific Bright Futures Visits (Bright Futures Toolkit), published by the American Academy of Pediatrics (AAP).

• Screening for the child’s parent(s) or caregiver(s) for postpartum depression should occur at every preventive pediatric visit from the 1-month visit to the 12-month visit. Providers should use a standardized screening tool, such as the Edinburgh Postpartum Depression Scale (EPDS) or any of the recommended postpartum depression screening tools listed in the Bright Futures Toolkit.
• Developmental surveillance should occur at each preventive visit from newborn to age 21, except at visits when developmental screening is being done. Developmental screening tests are recommended at 9, 18, and 30 months, but may also be applied at any visit when developmental surveillance elicits a concern. Providers should use one of the age-appropriate standardized developmental screening tools in the Bright Futures Toolkit.
• In addition to general developmental screening, autism screening should occur at the 18- and 24-month preventive visits, using one of the standardized autism screening tools listed in the Bright Futures Toolkit.

• Risk assessment for tobacco, alcohol, and drug use should be performed at every preventive healthcare visit from ages 11 to 21 years. It is recommended that providers use a standardized substance screening tool from the Bright Futures Toolkit.
• Screening for depression should occur at every preventive healthcare visit from ages 12 to 21, using a standardized depression screening tool, such as the Patient Health Questionnaire Modified for Adolescents (PHQ-9 Modified), or other tools available in the Guidelines for Adolescent Depression in Primary Care (GLAD-PC) toolkit.

Please review Appendix W of the MassHealth provider manuals. Appendix W also includes guidance on how to address certain positive screens.

For information on appropriate service codes for these screenings, please refer to Appendix Z (EPSDT/PPHSD Screening Services Codes) of the MassHealth provider manuals.