How do i fill out an epsdt nc form 2025

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The EP modifier identifies the type of service provided to Medicaid members under age 21. Claims will be denied if the section is left blank on CMS-1500 or UB04 forms.
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.
The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service is Medicaids comprehensive and preventive child health program for individuals under the age of 21. EPSDT guarantees health care resources are available and accessible, and helps Medicaid recipients and their caregivers use them.
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.
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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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.
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.

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