Annual Well Exam

Health Maintenance

Following the Iowa EPDST Care for Kids Periodicity Schedule, the annual well exam provides the opportunity to:

  • identify concerns through comprehensive assessment of the child and family; and
  • develop a care plan that is responsive to the family’s strengths, needs and choices.

IA EPSDT Screening

Regular EPSDT Screening

Iowa EPSDT screening requirements include comprehensive histories, physical exams, age-appropriate screenings, immunizations and anticipatory guidance.

As part of EPSDT screening, all children should receive annual well exams to detect potential problems. Refer to the Iowa Periodicity Schedule and explanation for additional information on required EPSDT screenings.

This website provides additional information about developmental screening and care, and mental health screening and care.

Interperiodic Screening

EPSDT benefits include medically necessary “interperiodic” screening outside of the Periodicity Schedule. Coverage is required:

  • for a medical need to diagnose an illness or condition not present at the regularly scheduled screening
  • to determine if there has been a change in a previously diagnosed illness or condition that requires additional services

The determination of whether a screening service outside of the Periodicity Schedule is necessary may be made by the child’s physician or dentist, or by a health, developmental or educational professional outside the formal health care system.

Well Exam

The annual well exam includes:

  • Comprehensive histories and assessment of physical and mental health, development, and nutrition. Bright Futures is an excellent resource for providing comprehensive care.
  • To assess family risk factors: Use the Bright Futures Pediatric Intake Form.
  • Unclothed/undressed and draped physical exam:
    • Use the WHO growth charts to monitor growth for infants and children ages 0 to 2 years of age in the U.S.
    • Use the CDC growth charts to monitor growth for children age 2 years and older in the U.S.
  • Age-appropriate immunizations: Follow CDC immunization guidelines.
  • AAP provides guidance on pediatric vision screening and hearing assessments for infants and children. Iowa law requires vision screening for children in kindergarten and third grade, and hearing screening of all newborns.
  • Iowa law requires that children under the age of 12 years who receive Medicaid must have a dental home. See the I-Smile Dental Home Initiative and visit our Periodicity Schedule page for more information. AAP provides Oral Health Practice Tools for guidance on the oral health exam. 
  • Age-appropriate laboratory tests, including blood lead level assessments at certain ages.
  • Health education and anticipatory guidance:
    • Bright Futures is an excellent resource and provides Family Materials.
    • Iowa State University provides anticipatory guidance handouts for families. Download a series of "Ages and Stages" brochures at no cost from ISU Extension and Outreach. These brochures are also available in a Spanish version, Edades.

Recommended Links

Please visit our Resources page to find medical home resources for these special needs populations:

  • International Adoption
  • Immigrant Screening
  • Genetic Disorders
  • Other Disorders

Tools for Examination

Iowa Periodicity Schedule

The Iowa EPSDT Periodicity Schedule provides health maintenance recommendations and information about the frequency and content of each EPSDT well-child/preventative health screening exam.

AAP's Bright Futures

EPSDT Care for Kids recommends the Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th Edition. In addition to this book and pocket guide, Bright Futures offers tool kits, including pre-visit questionnaires, visit forms, and educational material for families.

Website Accessibility

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