Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) is a health program for children under the age of 21 who are enrolled in Medicaid. The goal of EPSDT is to find and treat childhood health conditions before they become serious.
EPSDT means:
- Early: Catching health problems or risks early
- Periodic: Regular check-ups
- Screening: Physical, mental, developmental, dental, hearing, vision and other screening tests
- Diagnostic: Tests to follow up when a risk is found
- Treatment: Control, correct or reduce found health problems
Services covered by EPSDT
The EPSDT Program covers services and treatments such as:
- Regular medical check-ups
- Immunizations (vaccines) and lab tests
- Lead screenings
- Vision and hearing tests
- Health education and counseling
- Pediatric Developmental Screenings
The EPSDT program makes sure that children get the health care they need, as soon as they need it!
If a provider decides that a child needs a treatment or service, EPSDT will cover the service – even if there is a limit or the service is not covered by Medicaid for adults. Prior authorization may be needed. EPSDT does not cover services or items that are unsafe or experimental.
Getting EPSDT Services
Ask your child’s primary care provider (PCP) or a member of their care team about getting EPSDT services.
No-cost transportation services for EPSDT appointments may be available. Please call Neighborhood Member Services for more information about transportation services.
Member Rights
Neighborhood members have the right to file a grievance or an appeal if a request or service is denied. To file a grievance or appeal, please call Neighborhood Member Services at 401-459-6019 (TTY 711).
Members may also file an appeal with the State of Rhode Island Medicaid Program. To appeal and ask for a State Fair Hearing, call the Executive Office of Health and Human Services (EOHHS) at 401-462-2132 (TTY 711) or email OHHS.AppealsOffice@ohhs.ri.gov.
#3687 Approved 09/22/26