April 01, 2022

Tennessee: What you need to know about EPSDT screenings

The early and periodic screening, diagnostic and treatment (EPSDT) screening benefit of UnitedHealthcare Community plan helps provide comprehensive and preventative health care services for children from birth through age 20. Screening, diagnosis, and treatment services include:

  • Comprehensive health history
  • Comprehensive physical exam
  • Appropriate immunizations
  • Laboratory tests
  • Health education
  • Vision services
  • Dental services
  • Hearing services

We cover these services for acute, episodic, chronic illnesses and chronic conditions.

Additional visits
Sometimes an EPSDT exam may not be completed in a single visit. Facilitate appointment scheduling and, if needed, transportation assistance as soon as possible. Document the dates and the reason additional visits were needed.

Prior authorization
No prior authorization is required for TennCare Kids screenings. However, referrals are required for a specialist. You can submit a referral through UHCprovider.com or call Provider Services at 800-690-1606.

Dental screening
We encourage you to refer children to dentists for periodic dental screenings no later than age 3 and, if needed, as early as 6 to 12 months following the American Academy of Pediatric Dentistry guidelines.

The medical record should contain complete documentation of all care delivered from all providers who provide services.

Questions?
Call Provider Services at 800-690-1606.

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