CYSHCN Outreach Materials

• Camp Burnt Gin English Brochure (pdf)
• Camp Burnt Gin Spanish Brochure (pdf)
• CYSHCN Flyer (pdf)
• CYSHCN Brochure (pdf)

Reimbursement Rates, Authorized Equipment & Supplies, and Fee Schedules

• Provider Reimbursement Information (pdf)
• Physician Fee Schedule (pdf)
• Pediatric Subspecialist Fee Schedule (pdf)
• Hearing Services Fee Schedule (pdf)
• Orthodontic Fee Schedule (pdf)
• Dental Fee Schedule (pdf)

Forms and Manuals

• CYSHCN Services Request Form (DPH 4290) (pdf)
• CYSHCN Prescription for the Provision of Formula and Nutritional Supplements (DPH 4006) (pdf)
• Orthodontia Provider Manual (pdf)

Provider Lists

• Orthotic Prosthetic Provider List (pdf)
• Learn more about DPH's Services for Children with Special Health Care Needs