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EPSDT Personal Care Services Plan of Care - Louisiana Medicaid

EPSDT Personal Care Services Plan of Care - Louisiana Medicaid 2025

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The document is a form from the Louisiana Department of Health and Hospitals for requesting EPSDT Personal Care Services (PCS) for individuals needing assistance with daily living activities. It includes sections for identifying information, medical reasons, current services, personal care tasks, child care arrangements, and required signatures from the parent/guardian, provider representative, and physician.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Identifying Information' section. Enter the recipient's name, date of birth, and address. Ensure accuracy as this information is crucial for processing.
In the 'Provider Information' section, input the provider agency name, ID number, and contact details. This helps establish communication between all parties involved.
Detail the 'Medical Reasons Supporting the Need for PCS'. Attach any necessary medical documentation to substantiate the request.
Specify personal care tasks in the designated area. Clearly outline each activity required, such as bathing or meal prep, along with the total time requested for each task.
Complete the 'Child Care Arrangements' section if applicable, ensuring that care arrangements are clearly defined for children under 15 or those unable to self-direct.
Finally, gather signatures from all required parties including parent/guardian and provider representative before submitting your form.

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Does EPSDT cover items that are not available under the Medicaid state plan?

14 defines medical necessity for EPSDT services as follows: The state requires that Medicaid covers medically necessary services identified in a childs EPSDT screening whether or not such services are covered in the State Plan.

What consequences will a state face for failure to provide EPSDT services to Medicaid recipients?

Consequences: States that do not provide Medicaid recipients with EPSDT services run the risk of facing federal penalties, including losing access to federal Medicaid funding. This implementation guarantees that states consent to the norms to give extensive medical care to qualified youngsters and teenagers.

What is the modifier for the EPSDT?

If the first 5 or more components of an HCY/EPSDT screen are completed, you may bill using the age appropriate CPT code, EP modifier (along with modifier 52 to identify a partial screen was performed), and appropriate ICD-10 code to count toward your Participation Rate.

What is the EPSDT program in Louisiana?

The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program is a comprehensive and preventive child health program for individuals under the age of 21.

What is the coordination of benefits for Medicaid?

Coordination of Benefits (COB) refers to the activities involved in determining Medicaid benefits when an enrollee has coverage through an individual, entity, insurance, or program that is liable to pay for health care services.

What is the meaning of EPSDT procedure?

Early and Periodic Screening, Diagnostic, and Treatment. Early and Periodic Screening, Diagnostic, Treatment (EPSDT) is a Medi-Cal benefit for individuals under the age of 21 who have full-scope Medi-Cal eligibility. This benefit allows for periodic screenings to determine health care needs.

What is the EPSDT benefit for Medicaid?

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid.

EPSDT Personal Care Services Plan of Care - Louisiana Medicaid 2025

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