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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 eligible 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

2019 Immunization Schedules

The 2019 Child and Adolescent Immunization Schedule for children birth through 18 years old and the 2019 Adult Immunization Schedule for individuals 19 years and older have been posted on the Centers for Disease Control and Prevention (CDC) website here. These immunization schedules are approved by the CDC’s Advisory Committee on Immunization Practices (ACIP),  the American Academy of Pediatricsthe American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists.

Current recommendations and guidelines for each vaccine can be found at http://www.cdc.gov/vaccines/hcp/acip-recs.

All vaccine providers, public or private, are required by the National Vaccine Childhood Injury Act to give the appropriate Vaccine Information Statement (VIS) to the patient (or parent or legal representative) for each vaccine administered.  The appropriate VIS must be given prior to the vaccination and must be given prior to each dose of a multi-dose series. It must be given regardless of the age of the recipient.  Information on VIS is available from the CDC at http://www.cdc.gov/vaccines/hcp/vis/index.html.

2018 County Immunization Data

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. Iowa Department of Public Health Childhood Lead Poisoning Risk Questionnaire
  2. Basic Lead Testing Chart
  3. Schedule for Obtaining Confirmatory Venipunctures
  4. Capillary or Venous Blood Lead Levels (5-9 µg/dL)
  5. Follow-up of Elevated Blood Lead Levels (10-14 µg/dL)
  6. Follow-up of Elevated Venous Blood Lead Levels (15-19 µg/dL)
  7. Follow-up of Elevated Venous Blood Lead Levels (Greater than or equal to 20 µg/dL)
  8. Timelines for Medical Follow-up, Home Nursing Visit, Developmental Follow-up, and Nutritional Follow-up
  9. Timelines for Environmental Follow-up
  10. Guidelines for Detection and Management of Asymptomatic Lead-Poisoned Children

FY20 Childhood Lead Poisoning Prevention Program Resources

CMS EPSDT Information:

The Centers for Medicare and Medicaid Services (CMS) EPSDT Web 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 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  PDF assists Title V Child & Adolescent 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 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 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://ncemch.org/knowledge/EPSDT.php .

Health Resources and Services Administration (HRSA) EPSDT Information:

The HRSA EPSDT Web site 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 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 provides information for providers about the Medicaid program.

Periodicity Schedule

The Iowa EPSDT Care for Kids Periodicity Schedule 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, 4th Edition adopted by the American Academy of Pediatrics (AAP) and supported by Iowa's Chapter of the AAP.

Medicaid Dental Periodicity for Children

Iowa’s periodicity schedule of dental services for Medicaid-enrolled children identifies the types of services recommended based upon the age of a child and risk for dental disease. The recommendations were developed using information from the American Academy of Pediatric Dentistry and also Iowa’s definition of a dental home.

For more information: 1-800-383-3826

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