Understanding Medicaid Home and Community Services: A Primer, 2010 Edition. Mandatory State Plan Services: EPSDT


The Federally mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program for children from birth until they turn age 21 entitles Medicaid-eligible children to services found necessary to diagnose, treat, or ameliorate a defect, physical or mental illness, or a condition identified by an EPSDT screen. The original 1967 legislation gave states the option to cover treatment services not covered under the Medicaid State Plan. In 1989, Congress strengthened the EPSDT mandate by requiring states to cover all treatment services defined under §1905(a), regardless of whether or not those services are covered in their Medicaid State Plan.28 As a result, EPSDT programs now cover the broadest possible array of Medicaid services, including personal care and other services provided in the home.

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