EPSDT Overview

Program Introduction

Iowa's Medicaid Program for Children and Teens

Iowa EPSDT Care for Kids are the state's federally mandated Medicaid benefits for children and adolescents. Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefits were created by Congress in 1967.

The role of EPSDT is to promote the physical, mental, social, emotional and behavioral health of children from birth to age 21. The EPSDT program emphasizes the use of a regular schedule of recommended well-child health visits and screenings to provide preventive health care and to identify medical, developmental and social-emotional concerns. The EPSDT program requires that Medicaid pay for any medically necessary diagnostic and treatment services for problems detected as part of a well-child screening exam.

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EPSDT - The Acronym



Children should receive quality health care beginning at birth and continuing throughout childhood and adolescence, including the identification, diagnosis and treatment of medical conditions as early as possible.



Children should receive well child visits at regular intervals throughout childhood and adolescence, according to the Iowa EPDST Periodicity Schedule. Health care may be provided between regularly scheduled visits.



Children should be screened for health and developmental and behavioral concerns. Services should include health history, developmental and behavioral assessment, physical exam, immunizations, lab tests, nutrition/obesity prevention, oral health exam, health education (anticipatory guidance), and vision and hearing screenings.



Children should receive further evaluation of health, developmental or social-emotional problems identified during well-child visits that may require treatment.



Children should receive treatment for health, developmental or social-emotional problems identified during well-child visits.

Program Goal

As a result of participating in Iowa EPSDT, each child should have an integrated plan of care based on the outcome of all recommended screenings. Each plan of care should consider the child within the context of the family, and the family within the context of the community.

Eligibility and Cost

All Iowa children who are enrolled in Medicaid are automatically enrolled in EPSDT Care for Kids. All EPSDT services are free to children enrolled in Medicaid.

More information about this federal Medicaid program is available at Early and Periodic Screening, Diagnosis and Treatment on the Medicaid.gov website.

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