Medicaid Schedule for CHILD HEALTH CHECK-UP

Child Health Check-Up (formerly known as Early and Periodic Screening, Diagnosis and Treatment [EPSDT] services) consists of a comprehensive, preventive health screening that is performed on a periodic basis on children under the age of 21.

A Child Health Check-Up includes a comprehensive:

(1) Health and developmental history; an assessment of past medical history, developmental history and behavioral health status; unclothed physical exam; nutritional assessment; developmental assessment; updating of routine immunizations; laboratory tests (including blood lead screening); vision, hearing, and dental screening (including dental referral); and
health education/anticipatory guidance.

(2) Referral and follow-up for further diagnosis and treatment as indicated as a result of the screening process.

Medicaid reimburses county health departments, Children’s Medical Services clinics, physicians, community health centers (rural health clinics and federally qualified health centers), physician assistants and advanced registered nurse practitioners for Child Health Check-Ups. Birth centers and licensed midwives may be reimbursed only for the initial Child Health Check-Up newborn evaluation.

The Child Health Check-Up schedule is as follows:

• Birth

• Two to four days if newborn is discharged in less than 48 hours

• By one month

• Two months

• Four months

• Six months

• Nine months

• Twelve months

• Fifteen months

• Eighteen months

• Once per year from age two through 20.

Note: Florida Medicaid recommends check-ups at 7 and 9 years of age for those children at risk.

Additional screening examinations may be provided on referral, if medically necessary, from a health care, developmental, or education professional or on request of a parent, guardian or the recipient.

A dental referral is provided for recipients beginning at age three, or earlier if indicated. Subsequent examinations by a dentist are recommended every six months or as prescribed by a dentist or other authorized provider. Vision and hearing screenings are provided according to an established periodicity schedule.

Please note:

Medicaid recipients under the age of 21 and children from age one through age 4 who are enrolled in the MediKids program are eligible for Child Health Check-Ups.

Reimbursement for a Child Health Check-Up is an all-inclusive fee under Title XIX (Medicaid) and Title XXI (MediKids). Immunizations and laboratory tests are reimbursed separately.

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