Feb. 17, 2026
A new clinical practice and billing guideline for Early and Periodic Screening, Diagnostic and Treatment services is available on our website, along with other Medicaid resources.
We developed this guideline to help providers:
- Improve health outcomes by ensuring that young members receive timely and appropriate screenings, diagnoses, and treatments.
- Standardize care by promoting uniformity in the delivery of EPSDT services, which helps members receive the same standard of care.
- Enhance preventive care by emphasizing the importance of preventive health measures, which are crucial in identifying and addressing health issues early.
The EPSDT program is a vital component of Medicaid that helps individuals under the age of 21 receive appropriate preventive health, dental, mental health, developmental and specialty services.
If you have any questions about EPSDT services or our clinical practice and billing guideline, email our Quality Improvement Department.
The material presented here is for informational and educational purposes only, is not intended to be medical advice or a definitive source for coding claims and is not a substitute for the independent medical judgment of a physician or other health care provider. Health care providers are encouraged to exercise their own independent medical judgment based upon their evaluation of their patients’ conditions and all available information, and to submit claims using the most appropriate codes based upon the medical record documentation and coding guidelines and reference materials. References to other third party sources or organizations are not a representation, warranty or endorsement of such organization. The fact that a service or treatment is described in this material, is not a guarantee that the service or treatment is a covered benefit, and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions.