The CMS Form-416 Report: Understanding its Use in Assessing Dental Care Utilization in Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Service for Children
Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) service forms the basis for the Nation’s largest dental benefits program for children. Long-standing concerns about Medicaid-eligible children’s ability to access dental services have focused considerable attention on reported measures of EPSDT dental service utilization. The most common source of data on children’s utilization of dental services in Medicaid is the federal Centers for Medicare and Medicaid Services (CMS) Form-416 report. Despite heavy reliance by policy makers, advocates, researchers and dental professionals on the CMS Form-416 report, there have been few publications concerning its origins, construction, revisions and uses. The purpose of this Technical Issue Brief is to provide a concise overview of those subjects, along with a commentary on the appropriate use of data found in the Form-416 report and measures that might be derived from them.
Don Schneider, DDS, MPH
Kathy L. Hayes, DMD, MPH
James J. Crall, DDS, ScD