EPSDT & MassHealth

Vicky Pulos

Medicaid's "Early and Periodic Screening, Diagnosis and Treatment" (EPSDT) benefit for children is a powerful tool advocates can use to help children and youth under age 21 enrolled in MassHealth Standard or CommonHealth get the health benefits they need. This memo provides citations to the applicable MassHealth regulations for obtaining EPSDT services not otherwise covered or for avoiding service limitations based on EPSDT. It also includes a quotation from the 2006 Rosie D decision describing the medical necessity standard for purposes of EPSDT. 

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EPSDT & MassHealth May 2019.pdf (329.02 KB) 329.02 KB