Child & Teen Checkups Program

CMS 416 Reports

State of Minnesota
CHB/Tribe

CHB/Tribe Line 10

Racial/Ethnic Groups
Fee-for-Service and Health Plan

CHB/Tribe Dental Services

Participation Reports

The CMS – 416 Report is a federal requirement for Minnesota’s annual reporting to the federal Centers for Medicare and Medicaid Services (CMS) on the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) or Child and Teen Checkups Program (C&TC) as it is called in Minnesota.

Individual county breakdown reports are created from the annual state report. The same methods are used to calculate all 14 line items for both state and county reports. The report line items include both Medical Assistance (MA) and MinnesotaCare enrolled children for both state and county reports.

Read the “Total” line when reviewing either the state or county reports. (CN or Categorically Needy, and MN or Medically Needy, are federal reporting categories, based on certain kinds of eligibility factors.)

State of Minnesota Participation Reports

FFY 2015 CMS-416 MN Statewide Participation ReportFFY 2014 CMS-416 MN Statewide Participation ReportFFY 2013 CMS-416 MN Statewide Participation ReportFFY 2012 CMS-416 MN Statewide Participation ReportFFY 2011 CMS-416 MN Statewide Participation Report

County and Tribe Participation Reports

FFY 2015 CMS-416 County and Tribe Participation ReportFFY 2014 CMS-416 County and Tribe Participation ReportFFY 2013 CMS-416 County and Tribe Participation ReportFFY 2012 CMS-416 County and Tribe Participation ReportFFY 2011 CMS-416 County and Tribe Participation Report

County and Tribe Line 10 Participation Reports

FFY 2015 CMS-416 Line 10 County and Tribe Participation ReportFFY 2014 CMS-416 Line 10 County and Tribe Participation ReportFFY 2013 CMS-416 Line 10 County and Tribe Participation ReportFFY 2012 CMS-416 Line 10 County and Tribe Participation ReportFFY 2011 CMS-416 Line 10 County and Tribe Participation Report

Race or Ethnicity Participation Reports

This report breaks the data out by race or ethnicity as reported on the Minnesota Health Care Programs application.

FFY 2015 CMS-416 by Race or EthnicityFFY 2014 CMS-416 by Race or EthnicityFFY 2013 CMS-416 by Race or EthnicityFFY 2009 CMS-416 by Race or Ethnicity

Fee for Service and Health Plan Participation Reports

FFY 2014 CMS-416 Fee for Service and Health Plan ParticipationFFY 2013 CMS-416 Fee for Service and Health Plan Participation

Foster Care Participation by County and Tribe

FFY 2015 CMS-416 Foster Care Participation by County and Tribe FFY 2014 CMS-416 Foster Care Participation by County and Tribe FFY 2013 CMS-416 Foster Care Participation by County and Tribe FFY 2012 CMS-416 Foster Care Participation by County and Tribe FFY 2011 CMS-416 Foster Care Participation by County and Tribe

CHB/Tribe Dental Services Participation Report

CMS-416 FFY 2003-2007 Children who received dental services


The CMS Website provides additional information about the CMS 416 Report, including line item definitions. Scroll to the EPSDT Data section of the page.

DHS image How to access PDF files

Rate/Report this page Report/Rate this page