Procedural Policy Guidance for Early Periodic Screening, Diagnosis and Treatment (EPSDT) and Health Check Program Guide Updates

Includes Consolidated Appropriations Act Section 5121 Guidance.

NC Medicaid has published an updated Early Periodic Screening, Diagnosis and Treatment (EPSDT) Procedural Policy, providing information about the EPSDT benefit available to individuals under the age of 21 and how to access those benefits for NC Medicaid Direct beneficiaries, and for those served by a Managed Care Organization. Please refer to the updated EPSDT Procedural Policy below for more information.

NC Medicaid has also published an updated Health Check Program Guide, including important information about preventive screenings for individuals under the age of 21. The update to the Health Check Guide also includes the latest guidance about the Consolidated Appropriations Act (CAA) Section 5121, which allows for payment of preventive screenings to eligible juveniles who are incarcerated. The update includes information about who is an eligible juvenile and what services are available to these beneficiaries under this statute. Please refer to the Health Check Program Guide below for more information.

ResourceWeb Address
Updated EPSDT Procedural Policyhttps://medicaid.ncdhhs.gov/documents/files/epsdt-policy-description/open
Updated Health Check Program Guidehttps://medicaid.ncdhhs.gov/documents/medicaid/epsdt/health-check-program-guide/open

Contact

NCTracks Call Center: 800-688-6696

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