Fee Schedule Current Legend Fee Schedule Archives
after Standardization		 Fee Schedule Archives
before Standardization		 Legend Archives
EPSDT Health Services - Provider Type 70 06/09/2025 01/01/2017
(effective 01/01/2017) (effective 06/30/2014)
NONE
EPSDT Preventive Services Fee Schedule 01/01/2021 NONE
(effective 01/01/2021) (effective 12/01/2013) (effective 07/01/2012)
NONE
EPSDT Personal Care Services Fee Schedule 04/01/2022 NONE
(effective 04/01/2022) (effective 07/01/2019) (effective 02/09/2007)
NONE
EPSDT Fee Schedules Current
Schedule
Effective Date		 Previous
Schedule
Effective Date		 Archives
EPSDT Support Coordination Fee schedule 07/01/25
PDF		 07/01/22
PDF		 01/01/22
PDF