What is EPSDT?
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program is a child health initiative for Medical Assistance members. Think of it like this:
- Early: Assessing and identifying problems early
- Periodic: Checking children's health at periodic, age-appropriate intervals
- Screening: Providing physical, mental, developmental, dental, hearing, vision, and other screening tests to detect potential problems
- Diagnostic: Performing diagnostic tests to follow up when a risk is identified, and
- Treatment: Control, correct or reduce health problems found.
Your child’s good health starts with having regular checkups with their primary care provider (PCP). Your child’s PCP will complete a yearly physical exam to make sure they are growing well, as well as conduct preventive screenings based on your child’s age, sex and medical history to make sure they do not have any health problems. For more information on our program and a checkups, screenings, and test schedule download our program brochure.
At a minimum, diagnosis and treatment for defects in vision, including eyeglasses. Vision services must be provided according to a distinct
periodicity schedule developed by the state and at other intervals as medically necessary. For additional information visit the
Vision and Hearing Screening Services for Children & Adolescents page.
At a minimum, dental services include relief of pain and infections, restoration of teeth, and maintenance of dental health.
Dental services may not be limited to emergency services. Each state is required to develop a dental periodicity schedule in consultation
with recognized dental organizations involved in child health.
States are required to provide any additional health care services that are coverable under the Federal Medicaid program and found to
be medically necessary to treat, correct or reduce illnesses and conditions discovered regardless of whether the service is covered in a
state's Medicaid plan. It is the responsibility of states to determine medical necessity on a case-by-case basis.
When a screening examination indicates the need for further evaluation of an individual's health, diagnostic services must be provided.
Necessary referrals should be made without delay and there should be follow-up to ensure the enrollee receives a complete diagnostic evaluation.
States should develop quality assurance procedures to assure that comprehensive care is provided.
Necessary health care services must be made available for treatment of all physical and mental illnesses
or conditions discovered by any screening and diagnostic procedures.