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.