Early and Periodic Screening. Diagnosis and Treatment (EPSDT)
Early and Periodic Screening. Diagnosis and Treatment (EPSDT) Services The federally mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, referred to as EPSDT in Indiana, is a preventive healthcare program designed to improve the overall health of Medicaid and CHIP-eligible individuals from birth through the month of their 21st birthday. EPSDT services are available for all Hoosier Care Connect members through the month of their 21st birthday. EPSDT is a required component of Indiana Health Coverage Programs (IHCP) managed care and fee-for-service (FFS) programs for members who fall within the age range for EPSDT. Specific rules about EPSDT services can be found in the IHCP Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Provider Reference Module and the Indiana Administrative Code 405 IAC 5-15. The Contractor must provide all covered EPSDT services in accordance with 405 IAC 5-15-8. In covering well-child visits, the Contractor shall follow the latest standards from the American Academy of Pediatrics (AAP) Bright Futures Guidelines. In addition, EPSDT services include the provision of medically necessary services to members less than twenty-one (21) years old in institutions for mental disease (IMDs). All requests for EPSDT services not otherwise covered under the State Plan must be reviewed for medical necessity for eligible members. The primary goal of EPSDT is to ensure that children enrolled in IHCP receive age- appropriate comprehensive, preventive services. Early detection and treatment can reduce the risk of more costly treatment or hospitalization resulting from delayed treatment. Per 40 CFR 159.153, hospitalization means admission for treatment to a hospital, clinic, or other health care facility. Treatment as an out-patient is not considered to be hospitalization. See 405 IAC 5-15-8 and the IHCP Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Provider Reference Module for details regarding components and recommended frequency of EPSDT screenings. The Contractor shall educate pregnant women and work with providers to educate women about the importance of EPSDT screenings and encourage them to schedule preventive visits for their infants. Additionally, the Contractor shall ensure that members receive a blood lead screening test, based on EPSDT guidelines and in accordance with HEA 1313. The Contractor shall also ensure that children who screen positive are enrolled in case management to ensure CDC recommended follow up ...
Early and Periodic Screening. Diagnostic, and Treatment (EPSDT) The Contractor shall provide EPSDT benefits to all Dental Health Plan Enrollees under age 21, including necessary health care, diagnostic services, treatment, and other measures described in Section 1905(a) of the Act to correct or ameliorate defects and physical and mental illnesses and conditions discovered during screening, whether or not such services are covered under the State Plan.
Early and Periodic Screening. Diagnosis and Treatment (EPSDT) services (except for well child care, including immunizations and lead screening and treatments)
Early and Periodic Screening. Diagnosis, and Treatment (EPSDT) or HealthCheck The Provider will render EPSDT services or make arrangements for EPSDT services to be provided to his/her eligible members in accordance with the HealthCheck periodicity schedule. PCP authorization and referrals can be made to other providers or school-based and local health departments for EPSDT screenings.
Early and Periodic Screening. Diagnosis and Treatment Program 13 (EPSDT): Program permitting a state to cover, under Medicaid law, known in 14 the State of California as “Medi-Cal,” services necessary to correct or 15 ameliorate a mental illness even if the service is not otherwise included in 16 the state’s Medi-Cal Plan. EPSDT covers eligible persons age twenty-one (21) 17 years and younger.
Early and Periodic Screening. Diagnosis and Treatment -------------------------------------------------------------------------------- CONTRACT NO.: P0HC-2002-D-0003 58 -------------------------------------------------------------------------------- --------------------------------------------------------------------------------
Early and Periodic Screening. Diagnostic and Treatment (EPSDT) The Contractor shall provide comprehensive health care services through primary prevention, early intervention, diagnosis and medically necessary treatment to correct or ameliorate defects and physical or mental illnesses discovered by the screenings for members under age 21. The Contractor shall ensure that these members receive required health screenings including a comprehensive history, developmental and behavioral health screenings, comprehensive unclothed physical examination, appropriate vision testing, hearing testing, laboratory tests, dental screenings and immunizations in compliance with the AHCCCS EPSDT periodicity schedule, and the AHCCCS dental periodicity schedule (Exhibit 430-1 and 430-1A in the AMPM), including appropriate oral health screening intended to identify oral pathology, including tooth decay and/or oral lesions, and the application of fluoride varnish conducted by a physician, physician’s assistant or nurse practitioner. The Contractor shall submit all applicable EPSDT reports as required by the AHCCCS Medical Policy Manual. EPSDT providers must document immunizations into the Arizona State Immunization Information System (ASIIS) and enroll every year in the Vaccine for Children (VFC) program.
Early and Periodic Screening. Diagnostic and Treatment (EPSDT) services in conformance with the scope of work Section on, Physical Health Care Covered Services, including a description of dental services coverage and limitations and the other EPSDT requirements in the scope of work;
Early and Periodic Screening. Diagnostic, and Treatment (EPSDT) The terms and conditions of Section 13, Exhibit B, Part 2 in the Medicaid Contract are incorporated by reference and have the same force and effect as though they are fully set forth herein.
