May 20, 2019
EPSDT Standards and Tracking Forms

Applicable to: Mercy Care Complete Care, Mercy Care RBHA, Mercy Care Long Term Care and Division of Developmental Disabilities

AHCCCS has recently updated their AHCCCS EPSDT Tracking Form - Policy 430, Attachment E. The EPSDT Tracking Forms are available on Mercy Care's website under EPSDT Standards and Tracking Form . They are also available on the AHCCCS website under the AHCCCS Medical Policy Manual (AMPM), Policy 430, Attachment E

We are advising you of this form update in order to avoid any unnecessary issues. 

As always, don't hesitate to contact your Mercy Care Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website.

Thanks for all you do!