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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE MEDICAID SERVICES FORM CMS-416: ANNUAL EPS DT PARTICIPATION REPORT State Code Fiscal Year Age Group
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Form CMS-416 Annual EPSDT is a report submitted by states to the Centers for Medicare & Medicaid Services (CMS) which provides information on the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program for Medicaid-eligible children.
States that administer the Medicaid program are required to file Form CMS-416 Annual EPSDT.
The specific instructions for filling out Form CMS-416 Annual EPSDT can be obtained from the Centers for Medicare & Medicaid Services (CMS). It is generally completed by states based on the data collected through the EPSDT program.
The purpose of Form CMS-416 Annual EPSDT is to monitor and assess the effectiveness of the EPSDT program in providing medically necessary and preventive services to Medicaid-eligible children. It helps CMS and states evaluate the quality of care and identify areas for improvement.
The specific information that must be reported on Form CMS-416 Annual EPSDT is outlined in the instructions provided by CMS. It typically includes data such as the number of Medicaid-eligible children receiving EPSDT services, the types of services provided, and the outcomes of those services.
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