Understanding Early and Periodic Screening, Diagnostic and Treatment Requirements

Last update: October 16, 2020

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services are an important part of preventive care for children. Required EPSDT services for all children, ages 2 to 20, in New Jersey include:

  • A comprehensive health and developmental history, including assessments of physical and mental health development and all diagnostic and treatment services that are medically necessary for a physical or mental condition identified during a screening visit
  • Anticipatory guidance, including counseling for nutrition and physical activity
  • A comprehensive unclothed physical examination, including vision and hearing screenings, dental inspection and nutritional assessment
  • Appropriate immunizations according to age, health history and the schedule established by the Advisory Committee on Immunization Practices (ACIP) for pediatric vaccines. Immunizations required by age 2 include:
    • Four diphtheria, tetanus and acellular pertussis (DTaP)
    • Three polio (IPV)
    • One measles, mumps and rubella (MMR)
    • Three haemophilus influenza type B (HiB)
    • Three hepatitis B (HepB)
    • One chicken pox (VZV)
    • Four pneumococcal conjugate (PCV)
    • One hepatitis A (HepA)
    • Rotavirus series (RV) – 2 doses of Rotarix or 3 doses of RotaTeq
    • Two Influenza vaccinations with different dates of service
  • Appropriate laboratory tests:
    • Lead screening, using blood-lead level determinations, must be done for every Medicaid-eligible and NJ FamilyCare child:
      • Between ages 9-18 months of age, preferably at 12 months
      • Between ages 18-26 months of age, preferably at 24 months
      • For any child between ages 27-72 months who have not yet been tested
    • Hemoglobin/hematocrit/EP
    • Urinalysis
    • Tuberculin test – intradermal, administered annually and when medically indicated
    • Additional laboratory tests may be appropriate and medically indicated (e.g., for ova and parasites) and shall be obtained as necessary.

Here’s the EPSDT screening schedule:

  • Neonatal exam
  • Under six weeks
  • Two months
  • Four months
  • Six months
  • Nine months
  • 12 months
  • 15 months
  • 18 months
  • 24 months
  • Annually through age 20

Dental services are another important part of EPSDT screenings. A referral to a dentist by age 1 or soon after the appearance of the first primary tooth is mandatory. After that, dental visits twice a year are recommended, with follow-up during well-child visits through age 20.