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For claims with dates of service before September 1, 2008: Why did I get paid only $20 instead of $65 for EPSDT claims?

April 26, 2017dates epsdt paid september 1 september 1 2008 service

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For claims with dates of service before September 1, 2008: Why did I get paid only $20 instead of $65 for EPSDT claims?

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Response: In order to receive the MA Fee of $65 for a complete EPSDT screening, providers must perform all required age-appropriate components of a complete screening based on the EPSDT Periodicity Schedule and Coding Matrix (PDF download). If required components are missing from the claim, the MA Fee of $65 will not be made. For additional information, see the EPSDT Billing Guide (PDF download). 8b. For claims with dates of service on and after September 1, 2008, please refer to Medical Assistance Bulletin 99-08-13.