The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service is Medicaid's comprehensive and preventive child health program for individuals under the age of 21. EPSDT guarantees health care resources are available and accessible, and helps Medicaid recipients and their caregivers use them. Health care professionals who work with children in Head Start programs, child care organizations, and clinics may access their state or territory's EPSDT schedule to ensure children's health needs are met.
Most states, territories, and the District of Columbia have adopted the Bright Futures/American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care. This schedule applies if your state or territory is not listed below.
The following states have a customized EPSDT schedule:
- Arizona (Section 430, Attachment A)
- Rhode Island
- West Virginia
See A Guide to the Dental Periodicity Schedule and Oral Exam for details about the dental periodicity schedule and when a child should receive an oral exam.
Consult the American Academy of Pediatric Dentistry for details about the dental periodicity schedule each state follows.
What You Need to Know
EPSDT is key to ensuring that children and adolescents receive appropriate preventive, dental, mental health, developmental, and specialty services. The EPSDT requirement includes children enrolled in a state’s Children’s Health Insurance Program. States and territories have different names for their EPSDT program, such as Healthy Kids, KanCare, or Husky.
- Early: Assess and identify problems early. Prevention can help ensure the early identification, diagnosis, and treatment of conditions before they become more complex and costly to treat. Children should receive all recommended preventive services and any medical treatment needed to promote healthy growth and development.
- Periodic: Have children's health checked at periodic, age-appropriate intervals by medical providers following a periodicity schedule, which shows the check-ups recommended at each age. Children and adolescents can also receive additional check-ups when a condition or problem is suspected.
- Screening: Provide physical, mental, developmental, dental, hearing, vision, and other screening tests to detect potential problems. All infants, children, and adolescents should receive regular well-child check-ups that include:
- Comprehensive health and developmental history, including both physical and mental health development assessments
- Physical exam
- Age-appropriate immunizations
- Vision and hearing tests
- Dental exam
- Laboratory tests, including blood lead level assessments at certain ages
- Health education, including anticipatory guidance
- Diagnostic: Perform diagnostic tests to follow up after identifying a risk. This includes diagnosis of mental health, substance use, vision, hearing, and dental problems. Also, include any necessary referrals so that the child or adolescent receives all needed treatment.
- Treatment: Control, correct, or reduce health problems found. In general, states and territories must provide and pay for any treatment that is considered “medically necessary” for the child or adolescent. This includes treatment for any vision and hearing problems, including eyeglasses and hearing aids. For children’s oral health, coverage includes regular preventive dental care and treatment to relieve pain and infections, restore teeth, and maintain dental health. Some orthodontia is also covered.
To support families who have questions about the services provided by EPSDT, share The Well-Child Visit: Why Go and What to Expect.
Resource Type: Article
National Centers: Health, Behavioral Health, and Safety
Last Updated: February 12, 2024