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EPSDT Providers

Early Periodic Screening, Diagnosis and Treatment (EPSDT) Care for Kids program

EPSDT Care for Kids is Iowa's federally mandated Medicaid program for children. The EPSDT Care for Kids program provides routine physicals or well-child check-ups for Medicaid eliglible children at certain specified ages. It is considered preventive care.

Who is eligible?

Children birth through age 20 years of age who have an active Iowa Medicaid card.

What services are provided?

Initial and periodic health check-ups include, but are not limited to, the following:

  • health history
  • physical exam
  • growth and development assessment
  • vision and hearing screening
  • dental screening and education
  • immunizations
  • developmental/behavioral screening
  • nutrition assessment and education
  • laboratory tests including blood lead testing
  • anticipatory guidance
  • referral for further diagnostic and treatment services, if needed

What resources are available to assist health care providers in implementing the EPSDT Care for Kids program?


Iowa EPSDT Coordinator Contacts

2014 Childhood Immunization Schedules:

The 2014 recommended immunization schedules for persons aged 0 - 18 years and the catch-up immunization schedule have been approved by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP). The 2014 recommendations are included on two schedules: one for children ages 0 through 18 years and a catch-up schedule.

Changes were published in the Morbidity and Mortality Weekly Report (MMWR) on February 7, 2014, in supplement volume 63, number 5 p. 108-109. For 2014, you will note the following:

  • The figures, footnotes, and tables are not being published in MMWR. Instead, a link to the CDC immunization schedule website is provided at http://www.cdc.gov/vaccines/schedules. This provides electronic access to the most current version of the schedules and footnotes on the CDC website. Health-care providers are advised to use both schedules and the combined footnotes together. Printable versions of the 2014 immunization schedules for persons aged 0 through 18 years also are available at the website in several formats, including portrait, landscape, and pocket-sized versions. Ordering instructions for laminated versions also are available at the website. "Parent-friendly" child and adolescent schedules are available at http://www.cdc.gov/vaccines/schedules/easy-to-read/index.html.
  • For further guidance on use of each vaccine included in the schedules, including contraindications and precautions to use of a vaccine, health-care providers are referred to the respective ACIP vaccine recommendations at http://www.cdc.gov/vaccines/hcp/acip-recs. In addition, changes in recommendations for specific vaccines might occur between annual updates to the childhood/adolescent immunization schedules.
  • These immunization schedules are approved by ACIP, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists.

The National Childhood Vaccine Injury Act requires that health-care providers provide parents or patients with copies of Vaccine Information Statements (VIS) before administering each dose of the vaccines listed in the schedules. Additional information on VIS is available from the CDC at www.cdc.gov/vaccines/pubs/vis/default.htm.

Blood Lead Testing Guidelines

Iowa's Blood Lead Testing Guidelines provide key information for addressing lead risk assessment for children and guidelines for blood lead testing and follow-up. Included in this document are the following:

  1. Determining Risk Through Asking Questions: Iowa Childhood Lead Poisoning Risk Questionnaire
  2. Testing the Child According to the Appropriate Schedule - Basic Lead Testing Chart
  3. Obtaining Confirmatory Venipunctures When Children Have Capillary Blood Lead Levels >15 Micrograms per Deciliter - Schedule for Obtaining Confirmatory Venipunctures
  4. Testing Children with Blood Lead levels of 10-14 Micrograms per Deciliter According to the Appropriate Schedule - Follow-up of Elevated Blood Lead Levels (10-14 µg/dL)
  5. Testing Children with Venous Blood Lead levels of 15-19 Micrograms per Deciliter According to the Appropriate Schedule - Follow-up of Elevated Venous Blood Lead Levels (15-19 µg/dL)
  6. Testing Children with Venous Blood Lead levels of >20 Micrograms per Deciliter According to the Appropriate Schedule - Follow-up of Elevated Venous Blood Lead Levels (Greater than or equal to 20 µg/dL)
  7. Providing Medical Follow-up, Home Nursing Visit, Developmental Follow-up, and Nutritional Follow-Up According to the Appropriate Schedule - Timelines for Medical Follow-up, Home Nursing Visit, Developmental Follow-up, and Nutritional Follow-up
  8. Providing Environmental Follow-up According to the Appropriate Schedule - Timelines for Environmental Follow-up

CAReS User Manual

The Child and Adolescent Reporting System (CAReS) is used by Title V Child Health agencies to document a client's demographic information, needs, and services provided. The CAReS User Manual  Adobe Acrobat Logo has been developed as a step-by-step guide for data entry.

CMS EPSDT Information:

The Centers for Medicare and Medicaid Services (CMS) EPSDT Web page  This item links to an outside page provides information on EPSDT benefits and state agency responsibilities and required activities.

CMS 416 Participation Rate Data

The Iowa Medicaid Enterprise reports EPSDT screening data to the Centers for Medicare and Medicaid Services (CMS) each Federal Fiscal Year (October 1 - September 30). The annual CMS 416 Report provides basic information on children's participation in the Medicaid program based upon this data. The information is used to assess the effectiveness of state EPSDT programs in terms of the number of Medicaid enrolled children who are provided screening services and referred for treatment. States are required to maintain a minimum Participation Rate of 80%. Participation Rates indicate the extent to which the number of Medicaid eligible members who should be screened during the year receive at least one initial or periodic screening service. The unit of measure is the number of Medicaid enrolled children receiving at least one initial or periodic screening service divided by the unduplicated count of Medicaid enrolled children who should receive at least one initial or periodic screening service in the year. The initial and periodic screening services are based on the Iowa Recommendations for Scheduling Care for Kids Screenings.

DHS Policy Manual for Screening Centers

The Iowa Medicaid Provider Manual for Screening Centers  Adobe Acrobat Logo  This item links to an outside page contains basic information concerning Iowa's Medical Assistance Program (Medicaid). All providers of medical and health services participating as a Medicaid Screening Center use this manual. It includes information on policies, procedures, and billing for this Medicaid program.

EPSDT Care for Kids Informing and Care Coordination Handbook

The EPSDT Care for Kids Informing and Care Coordination Handbook  Adobe Acrobat Logo assists Title V Child Health agencies and their subcontractors in implementing EPSDT Care for Kids informing and care coordination services.

EPSDT Care for Kids Newsletter

The EPSDT Care for Kids Newsletter  This item links to an outside page informs Iowa health care professionals about Iowa's EPSDT Care for Kids program. It is published three times a year and provides information about new developments in the field of children's health care. Archived newsletters date back to 2006.

EPSDT Care for Kids Provider Resource Web Page

This EPSDT Care for Kids Provider Resource Web page  This item links to an outside page provides information for Iowa's EPSDT Care for Kids professional providers. It contains useful tools, resources, and links for EPSDT Care for Kids services with special emphasis on promoting healthy physical, mental, social, and emotional development of children birth through age three.

EPSDT Knowledge Path - Maternal and Child Health Library

The Maternal and Child Health (MCH) Library, located at the National Center for Education in Maternal and Child Health at Georgetown University, is a virtual guide to MCH information. It offers a combination of MCH information compiled by library staff and pathways to the best MCH information available from other websites, organizations, and libraries. Knowledge paths on MCH related topics contain selections of recent, high quality resources and tools for staying abreast of new developments. Components of a knowledge path include links to websites, electronic publications, databases, discussion groups, and citations from journal articles and other print resources.

The EPSDT Knowledge Path includes guidelines for the frequency, timing, and content of health-promotion and disease-prevention services for infants, children, and adolescents. Separate sections present resources for professionals (health professionals, program administrators, policymakers, and researchers) and for families. A special topics area lists resources about oral health services as part of the EPSDT benefit. View the EPSDT Knowledge Path online at http://www.mchlibrary.info/KnowledgePaths/kp_EPSDT.html  This item links to an outside page.

Health Resources and Services Administration (HRSA) EPSDT Information:

The HRSA EPSDT Web site  This item links to an outside page provides information about how EPSDT works with public health, families, managed care organizations, pediatricians, and other health providers.

Iowa Child Health and Development Record forms (CHDR)

The Iowa Child Health and Development Record  This item links to an outside page forms are tools that serve as a guide for well child screening, anticipatory guidance, and documentation of the child's care plan. These forms are age-specific for young children from birth through age 5, based on the Iowa EPSDT Care for Kids Health Maintenance Recommendations.

Iowa Medicaid Enterprise (IME) Provider Services

The Iowa Medicaid Enterprise Provider Services  This item links to an outside page provides information for providers about the Medicaid program.

Periodicity Schedule

The Iowa EPSDT Care for Kids Health Maintenance Recommendations is commonly called the Periodicity Schedule. This document provides a one-page summary of the ages at which recommended health screening services are to be provided as a child grows. These guidelines are based upon Bright Futures, Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd Edition adopted by the American Academy of Pediatrics (AAP) and supported by Iowa's Chapter of the AAP.

For more information: 1-800-383-3826

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