We use cookies to improve security, personalize the user experience,
enhance our marketing activities (including cooperating with our marketing partners) and for other
business use.
Click "here" to read our Cookie Policy.
By clicking "Accept" you agree to the use of cookies. Read less
Early and Periodic Screening, Diagnosis, and Treatment Program
Understanding the Early and Periodic Screening, Diagnosis, and Treatment Program
Definition & Meaning
The Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) is a Medicaid initiative aimed at ensuring comprehensive and preventive health care for individuals under the age of 21. This program mandates that all states assess, treat, and improve any physical or mental health conditions identified in eligible children. States must also inform families about the benefits available through EPSDT and assist them in accessing necessary treatments.
Table of content
Legal Use & context
EPSDT is primarily utilized in the context of child health care under Medicaid. It is significant in civil law, particularly in health care and family law, as it ensures that children receive necessary medical services. Users can manage some aspects of this program through legal forms and templates provided by services like US Legal Forms, which are designed by qualified attorneys.
Key legal elements
Real-world examples
Here are a couple of examples of abatement:
For instance, a child diagnosed with a developmental delay may receive specialized therapies through EPSDT, even if those therapies are not typically covered under the state's Medicaid plan. (hypothetical example)
Relevant laws & statutes
The EPSDT program is defined by the Omnibus Budget Reconciliation Act of 1989 (OBRA '89) and is governed by Section 1905(r) of the Social Security Act. These laws outline the requirements for states to provide comprehensive health services to eligible children.
State-by-state differences
State
Key Differences
California
Offers additional mental health services under EPSDT.
Texas
Focuses on preventive care and has specific outreach programs for rural areas.
New York
Includes expanded dental and vision services compared to federal minimums.
This is not a complete list. State laws vary and users should consult local rules for specific guidance.
Comparison with related terms
Term
Definition
Difference
Medicaid
A federal and state program providing health coverage to low-income individuals.
EPSDT is a specific program within Medicaid focused on children.
CHIP
The Children's Health Insurance Program, which provides coverage to children in families with incomes too high to qualify for Medicaid.
EPSDT serves children eligible for Medicaid, while CHIP targets a different income bracket.
Common misunderstandings
What to do if this term applies to you
If you believe your child may be eligible for EPSDT services, start by contacting your state Medicaid office for information on available screenings and treatments. You can also explore US Legal Forms for templates that may help you navigate the application process. If you encounter complex issues, consider seeking assistance from a legal professional experienced in Medicaid matters.
Find the legal form that fits your case
Browse our library of 85,000+ state-specific legal templates.
Key Services: Screening, diagnosis, and treatment of physical and mental health conditions.
Legal Basis: Omnibus Budget Reconciliation Act of 1989 and Social Security Act.
State Variability: Services may differ by state.
Key takeaways
Frequently asked questions
EPSDT stands for Early and Periodic Screening, Diagnosis, and Treatment Program, which provides comprehensive health services for children under 21 enrolled in Medicaid.
Children under the age of 21 who are enrolled in Medicaid are eligible for EPSDT services.
EPSDT covers preventive screenings, diagnosis, and treatment for physical and mental health conditions, including dental and vision services.
No, while all states must provide EPSDT services, the specific offerings can vary significantly from state to state.