EPSDT. The Contractor agrees to work with contracted providers to provide the full early and periodic screening, diagnosis, and treatment services to all eligible children, pregnant women, unborn children, and young adults up to age 21 in accordance with the Rhode Island EPSDT Periodicity Schedule, that assures that all EPSDT billable services are coded with established CPT/HCPC codes and submitted through the normal administrative claims processes as included in ATTACHMENT ED or modified by EOHHS during the period of this Agreement. In addition, the Contractor agrees to have written policies and procedures for conducting tracking, follow-up, and outreach to ensure compliance with Rhode Island EPSDT Periodicity Schedule. These policies and procedures will emphasize outreach and compliance monitoring for children and adolescents (young adults), considering the multi-lingual, multi-cultural nature of the population as well as other unique characteristics of this population. The full scope of the Contractor’s EPSDT requirements is described below.
EPSDT. Enter the specified code indicating the child was referred for specialty services by the EPSDT screening.
EPSDT. EPSDT screens for any new enrollee under the age of twenty-one (21) must be scheduled within forty-five (45) days from the effective date of enrollment unless the child is already under the care of a PCP and the child is current with screens and immunizations. The Contractor must ensure that PCPs follow-up with those Members described in the above Section V.S.12 for any missed appointments. The PCP or specialist must send two (2) notices of missed appointments and make a follow-up telephone call to the Member for any missed appointments and the PCP or specialist must document these in the medical record.
EPSDT. (Early and Periodic Screening Diagnosis and Treatment of Individuals Under the Age of 21)
(a) Participating Provider shall report encounter data/claims associated with EPSDT screens, using a format approved by DPW, to Avesis within ninety (90) days from the date of service.
(b) EPSDT means the early and periodic screening, diagnosis and treatment of individuals under the age of twenty-one (21) conducted in accordance with the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1989 and Sections 1905(a) and (r)(5) of the Social Security Act, as well as, 42 CFR Part 441. Such screening, diagnosis and treatment shall be performed whether or not the service provided is a Covered Service.
EPSDT. (Early and Periodic Screening Diagnosis and Treatment of Individuals Under the Age of 21)
(a) Participating Provider shall report encounter data/claims associated with EPSDT screens, using a format approved by DPW, to Avesis within ninety (90) days from the date of service.
(b) EPSDT means the early and periodic screening, diagnosis and treatment of individuals under the age of twenty-one (21) conducted in accordance with the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1989 and Sections 1905(a) and (r)(5) of the Social Security Act, as well as, 42 CFR Part 441. Such screening, diagnosis and treatment shall be performed whether or not the service provided is a Covered Service.
(c) Should Participating Provider be unable to conduct the necessary EPSDT screens for Members under 21, Participating provider is responsible for arranging to have the necessary EPSDT screens performed by another Participating Provider. All relevant medical information, including the results of the EPSDT screens, are to be incorporated into the Member’s primary medical record.
EPSDT. In accordance with 42 U.S.C. §1396d(r), EPSDT means Early and Periodic Screening, Diagnosis and Treatment, a comprehensive set of services provided to all Medicaid-eligible children under age 21.
EPSDT. 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
