EPSDT and PPHSD Information and Resources

See below for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) and Preventive Pediatric Health Care Screening and Diagnosis (PPHSD) regulations and more.

Regulations

• 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.
• All Provider Bulletin 348: Updates to Developmental and Behavioral Health Screening Tools and Codes in Pediatric Primary Care, effective January 1, 2023.

Appendices

• Appendix W: EPSDT Services Medical and Dental Protocol and Periodicity Schedules – 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 – 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.

MassHealth Provider Manuals

• Acute Outpatient Hospital Manual
• Community Health Center Manual
• Physician Manual