EPSDT: The Basics

EPSDT is composed of:

• Early: Identifying and addressing health problems early
• Periodic: Checking children’s health at regular, age-appropriate intervals
• Screening: Conducting comprehensive exams including, physical, developmental, vision and hearing
• Diagnostic: Providing testing and evaluation when a risk or concern is identified
• Treatment: Delivering all medically necessary services to correct or ameliorate health conditions

EPSDT includes coverage for all medically necessary services to correct or ameliorate physical and mental conditions identified through screening, whether or not such services are covered under the Nevad State Plan, as required under federal Medicaid law (42 U.S.C 1396d)).

Nevada Medicaid utilizes the Bright Futures/American Academy of Pediatrics (AAP) periodicity schedule as the standard for EPSDT screenings, consistent with CMS guidelines.

Key Goals

The key goals of EPSDT in the state of Nevada are:

• Prevent illness and detect issues early
• Reduce long-term complications and healthcare costs
• Support children’s physical, behavioral, emotional, and developmental health
• Address comprehensive health needs including mental, emotional, and dental care

Exam Components

As required by Nevada Medicaid, a comprehensive EPSDT screening includes:

• Unclothed physical exam (unclothed means to the extent necessary to conduct a full, age-appropriate exam)
• Medical and family history
• Height, weight, BMI, and head circumference (as applicable)
• Vision and hearing screening
• Immunizations per Advisory Committee on Immunization Practices (ACIP) schedule
• Developmental and behavioral screening (for postpartum caregivers)
• Lab tests (including lead screening)
• Oral health and nutritional evaluation
• Adolescent risk screenings (tobacco, substance use, depression)
• Health education and anticipatory guidance
• Comprehensive health and developmental history (including physical and mental health)
• Blood pressure screening (per age-specific guidelines)
• Lead screening at age 12 and 24 months and as clinically indicated thereafter
• Tuberculosis risk assessment and testing as indicated
• Age-appropriate hearing screening using objective measures per Bright Future periodicity

State Periodicity Schedule

Providers must follow the Bright Futures/AAP periodicity schedule as adopted and required by Nevada Medicaid.

EPSDT Screening Timeline

Resources

Access the Navigate EPSDT Education Provider Toolkit for more information about EPSDT.