EPSDT

Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

EPSDT is a mandatory service of the Medicaid program and is included in every state’s Medicaid State Plan. EPSDT provides preventative services and treatment to Medicaid eligible children and youth under the age of 21.

Children’s needs are different than adults’. EPSDT was created to address those differences with more robust Medicaid offerings for children. EPSDT provides for routine health screenings to help prevent health problems for youth or to diagnose and treat them as early as possible.

 

AAICAMA Resources

AAICAMA EPSDT Factsheet

AAICAMA Practice Bulletin: EPSDT

 

The Center for Medicare and Medicaid Services (CMS)

The Centers for Medicare and Medicaid Services declares that “The goal of EPSDT is to assure that individual children get the health care they need when they need it – the right care to the right child at the right time in the right setting.”

 

CMS Resources

CMS Website EPSDT page

CMS EPSDT A Guide for States

 

Federal law: The Medicaid law on EPSDT can be found in the United States Code (USC) and Code of Federal Regulations (C.FR.)

Cite: 42 U.S.C. §1396d(r)                 U.S Code Medicaid Definitions EPSDT

Cite: 42 C.F.R. §441.50                    C.F.R. Medicaid EPSDT Basis Purpose

Cite : 42 C.F.R. §§441.55-441.62     C.F.R. Medicaid EPSDT Requirements and Services