and Behavioral Health Screening (Physician, Physician Assistant, Certified Nurse Practitioner, Certified Nurse Midwife, Certified Clinical Nurse Specialist, and Community Health Center Providers Only)

1. (A) Laboratory Services. The laboratory services that are listed in Appendix Z: EPSDT/PPHSD Screening Services Codes of all MassHealth provider manuals and included in the Medical Schedule are payable, in addition to the initial, periodic, or interperiodic visit, when they are performed and interpreted in the office of the provider who performed the initial, periodic, or interperiodic visit.
2. (B) Audiometric Hearing and Vision Tests. Payments for the audiometric hearing tests and the bilateral quantitative screening test of visual acuity that are listed in Appendix Z of all MassHealth provider manuals and included in the Medical Schedule, is not included in the fee for an initial, periodic, or interperiodic visit. Payment for these tests may be claimed separately.
3. (C) Behavioral Health Screening. Payment for the administration and scoring of one of the standardized behavioral health screening tools that is listed in Appendix Z of all MassHealth provider manuals and set forth in the Medical Schedule is not included in the fee for an initial, periodic, or interperiodic visit.

(130 CMR 450.147 Reserved)

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 1. Introduction

1-43

Provider Manual Series (130 CMR 450.000)

Transmittal Letter Date

All Provider Manuals

ALL-224 12/18/17