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*Participation rate is the percentage of eligible children who received at least one EPSDT screening (well-child) visit in the year.
Sources: Centers for Medicare and Medicaid Services (CMS), National Conference of State Legislatures, 2008.
Medicaid's Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program offers comprehensive preventive child health services to all Medicaid-eligible children under age 21. However, many enrolled children do not receive recommended screenings.
Children enrolled in Medicaid are eligible for services such as developmental screening, hearing and vision services, dental services, health education, and treatment through EPSDT. Given that most brain development occurs before age 5 and that one-third of America's children under age 6 are eligible for Medicaid, EPSDT can significantly affect early child development and school readiness. Finding and treating problems early is a cost-effective investment.
Medicaid-reimbursed health care providers should use the EPSDT program to:
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Identify problems Early, starting at birth;
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Check children's health at Periodic, age-appropriate intervals;
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Conduct physical, mental, developmental, dental, hearing, vision, and other Screening tests to detect potential problems;
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Perform Diagnostic tests to follow up when a risk is identified; and
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Treat the problems found.
States report their EPSDT participation rates to the Centers for Medicare and Medicaid Services (CMS) annually. In 1995, CMS set a participant rate goal of 80 percent for states. Most states do not meet this goal (see reverse).
Sources: Centers for Medicare and Medicaid Services, 2008; Health Resources and Services Administration, 2008.
This webpage was adapted from an NCSL postcard published in December, 2008.
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Investing in a Healthy Start for Children || Maternal and Child Health Project
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