The Centers for Medicare & Medicaid Services (CMS) released guidance on state compliance with the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requirements under Medicaid and the Children’s Health Insurance Program (CHIP). Current law entitles eligible children under the age of 21 to Medicaid coverage of health care, diagnostic services, treatment, and other measures described that are medically necessary. This guidance provides an overview of EPSDT requirements and discusses policies, strategies, and best practices to maximize health care access and utilization for EPSDT-eligible children. Strategies include promoting EPSDT awareness and accessibility, expanding and using the child-focused (EPSDT) workforce in rural areas, and improving care for EPSDT-eligible children with specialized needs, including providing behavioral health services in Rural Health Clinics. Medicaid and CHIP covers about 47 percent of children in rural areas and small towns.
