The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program is a comprehensive child health program under Medicaid aimed at ensuring that eligible children receive appropriate preventive, dental, mental health, and developmental services. Here's some important information about the EPSDT program:

 

Eligibility:

• All Medicaid recipients who aged 0 through 20 years of age are eligible for EPSDT services.

• Children receiving Individual Family Support waiver services are not eligible for EPSDT services. However, once they have exhausted those waiver services, they become eligible for EPSDT Personal Care Services (PCS).

 

Covered Services:

EPSDT Personal Care Services cover various basic personal care and support activities for eligible children. These services include:

1. Toileting and Grooming Activities: Assisting with tasks related to toileting and personal grooming.

2. Assistance with Bladder and/or Bowel Requirements or Problems: Providing support for children who may have special needs related to bladder and bowel functions.

3. Assistance with Eating and Food Preparation: Helping children with eating and meal preparation as necessary.

4. Performance of Incidental Household Chores: Limited to chores that directly benefit the recipient, such as tidying up the recipient's living space.

5. Accompanying to Medical Appointments: Providing support by accompanying the child to medical appointments. Note that this service does not include transportation.

 

Exclusions:

It's important to note that EPSDT Personal Care Services do not cover medical tasks such as:

• Medication Administration

• Tube Feedings

• Urinary Catheters

• Ostomy Care (care for an opening in the abdomen for waste elimination)

• Tracheostomy Care (care for an opening in the windpipe)

 

Additionally, the information mentions that recipients of the Children's Choice Waiver can receive both PCS and Family Support Services on the same day, but these services should not be rendered at the same time.