General and Behavioral Health Screening Under EPSDT for Adolescents in New York Medicaid Managed Care

In this cross-sectional study of adolescents in New York Medicaid from 2016 to 2021, BH screening rates remained far lower than general EPSDT screening rates, with wide variation across MCOs and limited alignment with state-assigned MCO quality ratings. These gaps may reflect long-standing structural challenges, including previously voluntary reporting of adolescent depression screening by the Centers for Medicare & Medicaid Services under the Mandatory Core Set of Behavioral Health Measures for Medicaid and Children's Health Insurance Program. Incorporating now-mandatory BH measures into MCO performance benchmarks could increase adolescent BH screening rates, strengthen accountability, support earlier detection of mental health conditions, and reduce variation in preventive care delivery both in New York and nationwide.