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This knowledge path points to resources about providing and strengthening Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid. It includes tools for state Medicaid programs, health care practices, training, and finding data and statistics, journal articles, reports, and other materials.

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Resources for Professionals

1. Overview ▼ Show

  • The EPSDT benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. States are given some flexibility in determining the periodicity or timing of the health visits and screenings, but the content of services is mandated by federal law to include the following:
    • Comprehensive health and developmental history, including a developmental assessment of physical and mental health
    • Comprehensive physical examination
    • Immunizations, based on the current approved Advisory Committee on Immunization Practices schedule
    • Laboratory tests, including lead toxicity screening
    • Vision, hearing, and dental services and other necessary health care services
    • Health education (anticipatory guidance including child development, healthy lifestyles, and injury and disease prevention)
    • Diagnosis and treatment
    See the Centers for Medicare and Medicaid Services (CMS) overview of program details.

2. EPSDT Policy: resources from 6 key websites▼ Show

  • Catalyst Center: Medicaid and Children with Special Health Care Needs. Fact sheets, infographic, tutorial, webinars, and other resources for policymakers, program administrators, and health professionals about the role that Medicaid and the EPSDT benefit play in supporting the health and well-being of children with special health care needs and their families.
  • Center for Children and Families (CCF): Medicaid. Analyses of policy developments and implementation efforts related to Medicaid on topics that include delivery system reform; eligibility and coverage; facts and statistics; financing; legislation, regulation, and guidance; program design; and waivers.
  • Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB): EPSDT and Title V Collaboration to Improve Child Health. Information about EPSDT and about opportunities for collaboration between Title V and Medicaid to improve EPSDT services. Presents strategies for improving EPSDT administration and performance. Resources address systems of care issues, family supports, data monitoring, and evolving EPSDT policy.
  • Medicaid.gov: Early and Periodic Screening, Diagnostic and Treatment. Information about services covered, state program guidelines, periodicity schedules, and data. Includes a set of strategy guides, each on a specific topic, to support states and their partners as they implement the EPSDT benefit. Oral health, adolescent well care visits, mental health and substance use, and lead screening are some of the topics addressed. More broadly, Medicaid.gov presents information about Medicaid, the Children's Health Insurance Program (CHIP), and the Patient Protection and Affordable Care Act (ACA), including federal policy guidance and state-specific program information and data. Topics include benefits, cost sharing, delivery systems, eligibility, financing and reimbursement, managed care, outreach and enrollment, and quality of care.
  • National Academy for State Health Policy (NASHP): Resources to Improve Medicaid for Children and Adolescents. Information about strategies states use to ensure children and adolescents enrolled in Medicaid receive EPSDT services. Topics include medical necessity, initiatives to improve access, reporting and data collection, behavioral health, support to providers and families, care coordination, and oral health.
  • National Health Law Program (NHeLP): Early and Periodic Screening, Diagnostic and Treatment. Resources about EPSDT that include fact sheets, issue briefs, case dockets, legal transmittals, and other resources. NHeLP litigates to ensure that eligible children receive the benefits to which they are legally entitled, provides technical assistance to state and local advocates working to implement EPSDT, and analyzes policies affecting children’s health.

3. Tools for Providing EPSDT Services: resources from 6 key websites ▼ Show

  • Bright Futures. Guidelines and tools for preventive health supervision and health screening for infants, children, and adolescents which can be used as a framework to improve EPSDT services. Includes health visit forms; developmental, behavioral, and psychosocial screening and assessment forms; an oral health risk assessment tool; and practice guides.
  • Centers for Disease Control and Prevention (CDC). Resources relevant to the provision of EPSDT services include
    Developmental Monitoring and Screening. Information about developmental screening and why it's important. Includes monitoring and screening recommendations for health professionals and suggestions for integrating screening services into primary care.
    Growth Charts. Tools and background information for plotting the growth of infants, children, and adolescents from birth through age 20. Also links to interactive training modules for health professionals using the pediatric growth charts in clinical and public health settings. The growth charts are available in English, Spanish, and French.
    Hearing Loss in Children. Information about hearing screening, diagnosis, treatment, and intervention. Includes recommendations and guidelines for newborn hearing programs and audiologic screening for infants and children.
    Immunization Schedules. Schedules and tracking tools for health professionals and families. Schedules are available in English and Spanish and in various formats.
    Lead. Information about childhood lead exposure and prevention. Includes guidelines for screening and case management.
    Newborn Screening. Program information, tools, and recommendations for health and lab professionals and families about newborn screening for certain genetic, endocrine, and metabolic disorders and hearing loss prior to discharge from a hospital or birthing center.
  • Early Childhood Learning and Knowledge Center (ECLKC): Health. Information and tools about health and development, program planning, working with families, and staff support related to the provision of EPSDT services in the Head Start community. Head Start is a national program that serves the development needs of infants and children from birth through age 5 and their families with low incomes through the provision of education, health, nutrition, social, and other services. Includes an online directory of Head Start programs and links to state EPSDT periodicity schedules and other resources.
  • National Center for Hearing Assessment and Management (NCHAM). Resources for health professionals, policymakers, and program administrators about the implementation and improvement of Early Hearing Detection and Intervention (EHDI) systems for infants and children covered by EPSDT services in Medicaid and by other health insurance programs. Includes information about EHDI program components, training tools, state EHDI profiles and contacts, and federal and state EHDI legislation.
  • National Maternal and Child Oral Health Resource Center (OHRC). Bibliography of materials about EPSDT oral health services, including a collection of reports about children’s utilization of these services in several states. OHRC also presents guidelines, schedules, health-education materials, and other resources for strengthening the oral health component of EPSDT services.
  • U.S. Preventive Services Task Force: Child and Adolescent Recommendations. Recommendations for preventive measures in primary care, including screening, counseling, immunizations, and preventive medications for cancer; cardiovascular disorders; development and behavior; infectious diseases; injury prevention; mental health conditions and substance abuse; metabolic, nutritional, and endocrine conditions; musculoskeletal disorders; perinatal care; and vision and hearing disorders.

4. Training ▼ Show

5. Journal Articles, Reports, Briefs, and Other Electronic Resources▼ Show

  • Conduct an automated search of the MCH Library's online catalog, MCHLine®, for publications, tools, and other resources about EPSDT.
    The MCH Library also houses the William McConway Hiscock Collection on Early and Periodic Screening, Diagnosis and Treatment, a collection of primarily reports and articles about EPSDT published between 1973 and 1982. A bibliography lists the documents by subject categories. Contact the library for a copy of the bibliography or to access the collection.
  • PubMed. Citations and abstracts for biomedical articles indexed by the National Library of Medicine (NLM), with links to full-text articles when available. Conduct an automated search for articles about EPSDT. Use the filters in the left sidebar to narrow your search by publication date, among other limits.

6. Data and Statistics▼ Show

  • The Centers for Medicare and Medicaid Services (CMS) collects information on state Medicaid and CHIP programs to assess the effectiveness of EPSDT. To view national and state data reports, go to the CMS overview of EPSDT and scroll to EPSDT Data (more than halfway down the page).
  • To see the percentage of children enrolled in Medicaid in each state and nationally, view the table, Health Insurance Coverage of Children 0-18, in State Health Facts by the Kaiser Family Foundation (KFF). Under Data View in the left sidebar, click on Number to see the number of children enrolled in Medicaid in each state and nationally.

7. MCH Library Guides on Related Topics▼ Show

Resources for Families

See the MCH Library family resource brief Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid.

Please provide feedback on this knowledge path.

Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid: Knowledge Path, 4th ed. (April 2014).

Author: Susan Brune Lorenzo, M.L.S., MCH Library.
Contributor: Beth DeFrancis, M.L.S., MCH Library.
Reviewers: Olivia K. Pickett, M.A., M.L.S., MCH Library; [ADD REVIEWERS' NAMES].