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The majority of infants and toddlers had at least one EPSDT or other well-child visit, with the probability of at least one visit increasing with age and enrollment duration (Table 3).
However, in FY93, the State's payment rate for an EPSDT visit was $30, compared with $50 for a comprehensive office visit.
It is surprising that CMS would approve a plan that flies in the face of EPSDT, especially for one of the first programs out of the box.
First, if any claims for the visit had a diagnostic or procedure code for well-child care, or an indication that an EPSDT screening was performed, the visit was flagged as including well-child care.
Center for Medicaid and Medicaid Services: Medicaid and EPSDT, undated.
The states are required to inform all Medicaid-eligible children of the availability of EPSDT services, to provide (or arrange the provision of) screening services in all cases when they are requested, and to arrange for (directly or through referral to appropriate agencies or providers) corrective treatment for which the child health screening indicates a need.
those performed by a dental professional without a supervisory relationship with a dentist or by another type of medical professional, do not meet the requirements of EPSDT.
For more information on EPSDT, please see http://mchb.
The development of the PCAF required the addition of items specific to the needs of children and a reformulation of other items so they applied to the EPSDT population.
First, during the EPSDT health center visit, parent coaches participated in the child health and developmental assessment and observed parent-health provider communication and interaction.
The EPSDT provision requires that states ensure that the services provided are reasonable effective and promptly provided.