We’re pleased to share that we provide coverage for a number of health care transition services under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit for Tufts Health RITogether members ages 14-21. 

In support of guidance from the Rhode Island Executive Office of Health and Human Services (EOHHS), the following core services, designed to assess and facilitate the transition from pediatric to adult primary health care, are available as of dates of service beginning July 1, 2025:

  • A pediatrician-administered health care transition assessment
  • Pediatric practice-driven education and counseling to address health care transitions, related skills, and goal setting (based on the transition assessment)
  • Preparation and updating of a medical transition summary by the pediatrician
  • Joint telehealth visits with the youth, pediatrician, and new adult primary care provider to facilitate the health care transition from pediatric to adult primary care provider

For information on how to bill for these services and more, refer to the state’s EOHHS EPSDT Billing Guidance for Transition Services, Children’s Services Policy, and Preventive Pediatric Schedule.

As a reminder, periodic and medically necessary EPSDT screenings and assessments do not require prior authorization or referral, and may be delivered in individual or group practices, hospital outpatient departments (acute, chronic, or rehabilitation), or community health centers (CHCs).