Department for Community Based Services

Standards of Practice Online Manual

4.26.5 Early Periodic Screening, Diagnosis and Treatment (EPSDT)

Cabinet for Health and Family Services

Department for Community Based Services
Division of Protection and Permanency
Standards of Practice Online Manual
Chapter:
Chapter 4-Out of Home Care Services (OOHC)
Effective:
5/1/2014
Section:
4.26.5 Early Periodic Screening, Diagnosis and Treatment (EPSDT)
Version:
2

When a section of SOP has been revised users will see the following: Added {This is added material}, Deleted {This is deleted material}. The bold and strikethroughs will appear on the site for fifteen (15) days after a modification and will then be removed.

 Resources

External Website:

Legal Authority/Introduction

LEGAL AUTHORITY:

  • N/A

Procedure 

The SSW: 

  1. Follows procedures outlined in SOP 4.26 Meeting Basic Health Care Needs;
  2. Documents the use of EPSDT services when appropriate.

Practice Guidance

  • A child in OOHC who is eligible for Medicaid is also eligible for EPSDT services, such as:
    • Immunizations;
    • Hearing tests;
    • Vision tests;
    • Physical health examination; and
    • Other services for early detection of conditions and provisions of routine well child care.
  • A child in OOHC who is eligible for Medicaid may also be eligible for EPSDT special services, which are not routinely covered by Medicaid, but are medically necessary and pre-authorized by Medicaid. For example, if a provider can demonstrate medical necessity for unique durable medical equipment, EPSDT special services may cover its cost.
 

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