Program Overview
The Early Periodic Screening, Diagnosis and Treatment (EPSDT) program combines screening, diagnostic and treatment services to Medicaid-eligible individuals from birth to age 21. These services give children early access to preventive and comprehensive health care to help prevent disease and/or detect disabilities in their early stages, when they are more effectively treated.
References:
AAP “Bright Futures” Recommendations and Content of Complete Encounters for Periodic Screening
EPSDT Overview
- UnitedHealthcare Care Provider Manual (Chapter 5, Pages 57 - 61 only)
- North Carolina DHHS EPSDT
- North Carolina DHHS Medicaid Benefit for Children and Adolescents Under Age 21
Medical Necessity Requirements of Federal EPSDT Law, Including Details of Meeting EPSDT Criteria, When Submitting Prior Approval Requests
- The Pediatric Medical Necessity Review and EPSDT Guarantee
- Listing of EPSDT Services found at 42 U.S.C. § 1396d(a) [1905(a) of the Social Security Act
- EPSDT Policy Instructions
Dental Education and Outreach
- North Carolina DHHS Into the Mouths of Babes
- North Carolina Division of Medical Assistance Oral Health Periodicity Schedule
- North Carolina Medicaid Dental Services
Behavioral Health and Developmental Screening
Behavioral Health Screenings
- UnitedHealthcare Care Provider Manual (Chapter 7, Pages 65 - 67 only)
- Optum - Behavioral Health Toolkit for Medical Providers
- Bright Futures Implementation Tip Sheet - Promoting Mental Health
Developmental Screenings
Early Intervention, Care Coordination, and other State and Community Services
- North Carolina Early Childhood Action Plan (Pages 15 - 17 Preventive Health Services)
- Provider Playbook 2019 North Carolina Medicaid - Early Intervention Services in Medicaid Managed Care
- North Carolina DHHS Early Intervention