Medicaid's Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Program is a preventive primary health care program for eligible low-income children and teens ages birth to 21. EPSDT emphasizes preventive care, especially screening services, to promote good health and identify and treat problems early and effectively.

EPSDT is a joint federal-state partnership program administered by the Centers for Medicare & Medicaid Services (CMS). The program has two operational components:

• Assuring the availability and accessibility of required health care resources
• Helping Medicaid recipients and their parents or guardians effectively use these resources

CMS, state Medicaid agencies, and EPSDT providers have a shared obligation to ensure comprehensive pediatric preventive care for eligible children and teens, and to support their families in accessing the health services available through EPSDT.

For more information on EPSDT services, see the HealthCheck Resources page.

Required EPSDT Health Services

The EPSDT program mandates the following preventive health services:

• Screening services
  • Comprehensive health and developmental history (physical, mental, and developmental)
  • Comprehensive unclothed physical exam
  • Appropriate immunizations
  • Laboratory tests, including mandatory lead screening
  • Health education and anticipatory guidance
  • Vision screening
  • Hearing screening
  • Dental screening
  • Other necessary health care
• Diagnostic services, if needed for further evaluation
• Treatment (or referrals) to correct or improve health conditions

Periodicity Schedule

The EPSDT program requires each state to develop an approved schedule of preventive health visits at regular intervals that meet reasonable standards of medical practice. Vision, hearing, and dental screening services must also be provided at intervals specified by the state.

The following pages provide a general overview of HealthCheck, the District of Columbia's EPSDT program.