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1967 Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit is added to promote healthy child development and ame- liorate conditions that disable children. 1972 Supplemental Security Income (SSI) is enacted, providing cash assistance and Medicaid to children with disabilities.
What You Need to Know Comprehensive health and developmental history, including both physical and mental health development assessments. Physical exam. Age-appropriate immunizations. Vision and hearing tests. Dental exam. Laboratory tests, including blood lead level assessments at certain ages.
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.
EPSDT is made up of the following screening, diagnostic, and treatment services: Screening Services. Vision Hearing Services. Dental Services. Lead Screening. Immunizations/Vaccines for Children (VFC) Program. Other Necessary Health Care Services. Diagnostic Services. Treatment.
A. EPSDT stands for Early and Periodic Screening, Diagnostic and Treatment. The EPSDT benefit provides comprehensive and preventive health services for children under age 21 who are enrolled in Medicaid.
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Federal law requires states to provide certain mandatory benefits and allows states the choice of covering other optional benefits. Mandatory benefits include services including inpatient and outpatient hospital services, physician services, laboratory and x-ray services, and home health services, among others.

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