Modifier EP Update

Tufts Health Public Plans products

November 01, 2021  

Effective for dates of service on or after November 1, 2021, modifier EP will no longer be reimbursed at 137% of Tufts Health Public Plans fee schedule/allowed amount. Guidance from MassHealth indicates that the use of modifier EP is considered obsolete for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services for MassHealth members under the age of 21. Therefore, modifier EP will be considered an informational only modifier and will not impact reimbursement. For more information, refer to the Modifier Payment Policy.