Children's Resources: Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

What is EPSDT?
Federal and State law require that children (up to age 21) who receive Medical Assistance – including Medicaid, PeachCare for Kids, and children in Medicaid Waivers – receive early and periodic screening, diagnosis and treatment (EPSDT).

This means that all children on Medical Assistance under age 21 get both well child visits AND all treatment and services that a professional says are necessary.

Rights of Children who Receive Medicaid
• The State should not put children on waitlists for services.
• Services should be available throughout the State.
• Services should be approved and provided or denied with “reasonable promptness.”
• The State should ensure that providers are available.
• Families should have the freedom to choose their provider.
• There should NOT be caps on the length or amount of services provided.

What Types of Services are Covered?
ANY SERVICE that a medical professional says is
MEDICALLY NECESSARY for a child.
The following services have been provided through EPSDT. There may be other services available:
• Healthy kid check-ups
• Case Management
• Physical, Occupational, and Speech Therapy
• Home Health Care
• Personal Care (in-home help with physical care)
• Private Duty Nursing (at home or in the community)
• Medical Equipment and Supplies
• Assistive Technology
• Therapeutic Behavioral Services (in-home aides)
• Mental Health Services
• Dental and Vision Care
• Therapeutic Nursery
• Medical Day Care
• Transportation to Appointments
• In-patient Hospital Care
• Limited Residential Services

You have an EPSDT issue if:
 You know a child who receives Medical Assistance (Medicaid, PeachCare for Kids, or Medicaid Waiver) AND
 The child has a need for services that has been identified or could be identified by a medical professional AND
 The child is not receiving the services, has been denied, placed on a waiting list, not received a response to an application for services in a reasonable time, been told the services are not available in that area, that there is a cap on the number of hours the service can be provided or the length of time it can be provided, or that there is no provider available

Please contact the Atlanta Legal Aid Society at 404-377-0705 x 275 (Mondays and Tuesdays) or 278 (Wednesdays and Thursdays). We may be able to advise you on the process to get EPSDT services and possibly provide you or refer you to free legal representation.

Click here for further information.