New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 309 - ALTERNATIVE BENEFIT PROGRAM
Part 4 - MAD ADMINISTERED BENEFITS AND LIMITATION OF SERVICES
Section 8.309.4.18 - EARLY AND PERIODIC SCREENING DIAGNOSIS AND TREATMENT SERVICES (EPSDT)
Current through Register Vol. 35, No. 18, September 24, 2024
The benefit package includes the delivery of the federally mandated EPSDT program services [ 42 CFR Section 441.57] provided by a primary care provider (PCP) as detailed in 8.320.2 NMAC. These include the ABP benefit services found in Sections 12 through 17 of this rule.
A. General physical health EPSDT services: MAD makes available access to early intervention programs and services for an ABP eligible recipient identified in an EPSDT screen as being at-risk for developing or having a severe emotional, behavioral or neurobiological disorder. Unless otherwise specified in a service rule, ESPDT services are for an ABP eligible recipient under 21 years of age. For detailed description of each service, see 8.320.2 and for school based health services, see 8.320.6 NMAC. Additional NMAC citations may be included as reference.
B. Behavioral health EPSDT services: The benefit package includes services provided by a behavioral health practitioner for an ABP eligible recipient. See 8.321.2 NMAC for a detailed description of each service. MAD makes available access to early intervention programs and services for an ABP eligible recipient identified in his or her EPSDT screen as being at-risk for developing or having a severe emotional, behavioral or neurobiological disorder.
