EPSDT in Medicaid

The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit gives comprehensive and preventive health care services for kids under age 21 who are enrolled in Medicaid. Services are mandated by law to include:

Health and developmental history, including physical and mental health
Physical examination
Immunizations
Lab tests, including lead screening
Vision, hearing, and dental services
Health education about child development, nutrition, physical activity, and injury and disease prevention
Diagnosis and treatment

The goal of EPSDT is to diagnose and treat health problems as early as possible. If a child enrolled in Medicaid needs a medically necessary service that will alleviate a medical condition or prevent a condition from getting worse, then the state must provide it. States also must help families by letting them know about EPSDT services and helping them use the services, such as helping to schedule appointments and helping with transportation to medical care. Read details about the EPSDT benefit from HRSA's Maternal and Child Health Bureau web portal on EPSDT.

Use this resource brief to help find care, services, and support for your child, learn more about EPSDT, and find tools to help you play a more active role in your child's EPSDT-related visits.

Find Care, Services, and Support

Do you have questions about Medicaid eligibility? applying for Medicaid? EPSDT services? finding care? These resources will help you find people in your state who can help answer your questions.

Benefits.gov. Find eligibility criteria, program descriptions, and contact information in English and Spanish for each state's Medicaid program.
Catalyst Center Family Resources. Contact information in English and Spanish for state organizations and consumer assistance programs that help families understand their health insurance options and help them get health insurance for kids and teens with special health care needs.
Family Voices (FV). Family Voices in Your State and Family to Family Health Information Centers (F2F HICs) are family-run centers that provide free, confidential information and can help you find resources and services to provide and pay for health care for kids and teens with special health care needs. You can access local groups at the bottom of the homepage.
Health Resources and Services Administration (HRSA): Find a Health Center. Find a federally funded health center that provides free or low-cost care.
Insure Kids Now. Links to each state's child and teen health insurance program website. Available in English and Spanish. Telephone: (877) KIDS NOW (543-7669).
See the MCH Digital Library's Community Services Locator: An Online Directory for Finding Community Services for Children and Families.

Learn More About EPSDT

Medicaid.gov: Early and Periodic Screening, Diagnostic and Treatment. Information about the EPSDT benefit and services covered.
National Health Law Program (NHeLP). Information about EPSDT including an article and an executive summary about how EPSDT works.
Colorado has a family-friendly version of EPSDT rules and regulations (PDF - 45 KB) on its Medicaid EPSDT website that includes clear language about prevention and treatment services, as well as a state agency staff contact.
Iowa’s Title V MCH program has a webpage regarding EPSDT that includes information about benefits and visit schedules. It also gives families a toll-free number to contact one of the EPSDT care coordinators in each of the state’s 99 counties for assistance.
Parent-to-Parent of Vermont produced an excellent guide for parents (particularly those whose children have special health needs) called Six Ways to Access Medicaid/EPSDT (PDF - 1.35 MB).

Find Tools to Help You Play an Active Role in Your Child's EPSDT-Related Visits

American Academy of Pediatrics (AAP): Bright Futures. Health visit forms and handouts about each age and stage of development.
Bright Futures at Georgetown University: Family Materials. Booklets, tip sheets, and forms to help you play an active role in your kids’ health and well-being and to help you form partnerships with health professionals.
Centers for Disease Control and Prevention (CDC). Immunization schedules and information about developmental milestones, monitoring, and screening; hearing loss screening, diagnosis, treatment, and intervention; and newborn screening.
Family Voices: IMPACT on Health and Wellness. Information about raising kids, including kids with special health care needs, by age group or stage of development; a health care visit checklist; and other resources, including some in Spanish, to help you improve your kids' health and well-being.

Need More Information?

See the MCH Digital Library's Professional Resource Guide, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid, for resources about providing and strengthening EPSDT services.
See the MCH Digital Library's collection of family resource briefs on topics that include asthma, autism, health insurance and access to care, mental health, and more.

Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid: Family Resource Brief, 2nd ed. (July 2014; updated January 2021).

Author: Susan Brune Lorenzo, M.L.S., MCH Digital Library.
Reviewers: Lauren Agoratus, M.A., parent of a child with multiple disabilities, Family Voices and Family-to-Family Health Information Resource Center at the Statewide Parent Advocacy Network of N.J.; Beth Dworetzky, M.S., Catalyst Center; Olivia K. Pickett, M.A., M.L.S., MCH Digital Library.