Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) for Medicaid-Enrolled Individuals Under 21 Years of Age

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit is a federally mandated benefit under Title XIX of the Social Security Act. This benefit provides preventive and comprehensive health services for Medicaid-eligible infants, youth and participants up to the age of 21.  The primary goal is to offer prevention, early diagnosis and medically necessary treatment of conditions.  

EPSDT provides:

• Preventative care for members from newborn through age 20
• Complete medical, mental and behavioral health, and dental care
• Services and medicines
• Treatment for problems that are identified
• Intensive Behavioral Therapies (e.g. Applied Behavioral Analysis (ABA) services for members with an Autism Spectrum Disorder (ASD) diagnosis.

EPSDT checkups include:

• Complete physical exam
• Lab tests (as needed)
• Immunizations
• Vision/Hearing screening
• Developmental/Behavioral and Mental health screening (as needed)
• Referrals to specialists (as needed)
• Oral (mouth) check
• Prescription medications (as needed)

EPSDT is provided at no cost to you

Dental care is also covered for children under age 21

For help finding a dentist, call Community Case Management Corporation toll free at 1-888-792-1070.