Frequently Asked Questions

EPSDT

Medicaid's EPSDT Program is also known as the Well-Child Check-up program. It is officially known as the Early, Periodic, Screening, Diagnosis and Treatment program.

Below are some questions people often ask about Medicaid's EPSDT program.  Click on the questions to see the answers:

Medicaid's EPSDT program is a federally-mandated program that is designed to find children with actual or potential health problems and to screen, diagnose and treat the problems before they become permanent, lifelong disabilities. The program also offers preventive health services to Medicaid-eligible children under 21 years of age.
Certain EPSDT screenings are for "well-child" check-ups. However, an EPSDT screening visit or check-up may also be performed for a suspected medical, dental, vision, hearing or psychological problem so a referral can be issued for further diagnosis and treatment. This allows children to get more covered services.
It depends. All Patient 1st Primary Medical Providers (PMPs) are required to provide EPSDT screenings and many of them do that for their patients. If the PMP does not provide this service, they are required to sign an agreement with another doctor to perform EPSDT screenings. These may be done at a clinic or other office. The Patient 1st doctor is required to record information about these screening visits in their patient records.
EPSDT screenings may be performed by physicians, nurse practitioners, registered nurses and physician assistants. Non-physician providers may provide screenings at a physician's office, rural health clinic, federally-qualified health center (FQHC), health department or hospital. Two-year degree RNs must first complete a Medicaid-approved pediatric health assessment course or show proof of completion of a similar program of study.
Medical and behavioral health services are included. This includes medical, vision, dental, hearing and behavioral health screenings, plus follow-up care. Medicaid will pay for rides for this care. And, if your child's doctor finds a problem, Medicaid will pay for tests and treatments to fix the problem.
If medically necessary, Medicaid pays for services to treat mental and emotional health issues and substance abuse. Talk to your child's doctor. If a mental or behavioral health issue is found during a screening, your doctor can refer your child to a specialist or for more testing. This will allow your child to be evaluated and treated by a mental health provider.
Your child may be screened at any time. Periodic screenings or well-child checkups, are to be done based on the schedule set up by the American Academy of Pediatrics. This is six times in the first year of life, three times in the second year and once a year after that. If health problems come up in between those visits, then another type of screening can be done.
One of the best ways is to take your child for well-child check-ups. This is the time to talk with the doctor or nurse about anything about your child's health. Be sure to always mention if your child is not acting or feeling in a way that seems right to you. There are some other things that can help, such as information from Alabama's Early Intervention Program. To get more information, go to the Recipient Section of this website and click on "Educational Materials."