EPSDT is the Early and Periodic Screening, Diagnosis and Treatment Program (also known as the Healthy Kids Program) through the State Medicaid Program. This program establishes preventive care standards for children under the age of 21.
All primary care providers that treat Medicaid patients under the age of 21 must be EPSDT Certified.
Primary care providers are encouraged to set up a face-to-face appointment with a Healthy Kids Program Nurse Consultant to become trained in the administrative and clinical standards associated with this program. The training takes about a half-hour to complete and is performed right in your office. Once you are certified, the certification stays with you as long as you adhere to the standards of preventative health care described by the Maryland Healthy Kids Program.
All Board-certified providers in pediatrics, family medicine and internal medicine can become EPSDT-certified free of charge. Along with the no-cost training, EPSDT Certified Providers are given specialized services offered by the state and local health departments. These services are covered in the EPSDT training. Any primary care physician providing services to a Medicaid recipient under the age of 21 is subject to an audit through the Maryland Healthy Kids Program.
We hope that if you are not certified, you will take advantage of the EPSDT Training if you see Health Choice members under the age of 21. The Maryland Department of Health (formerly DHMH) has required all MCOs to notify a member if he/she has selected a PCP that is not EPSDT-certified. The member is sent a letter explaining that he/she has chosen a non-EPSDT-certified provider and the member can decide to either stay with his/her provider or switch to a provider who is EPSDT-certified.
To become certified, please call 410-767-1836 to set up a training date with a Healthy Kids Program Nurse Consultant or contact MedStar Family Choice Provider Relations at 800-905-1722 with any questions or concerns. Your MedStar Family Choice Provider Representative is ready to assist you with scheduling an official training in your office.
For detailed information on the Maryland Healthy Kids/EPSDT Program, click here for the EPSDT Provider Certification and Qualifications document.
The Maryland Healthy Kids Preventive Health Schedule (effective 1/1/18) is now available. The schedule reflects minimum standards required for all Maryland Medicaid recipients from birth to 21 years of age. The Maryland Healthy Kids Program requires yearly preventive care visits between ages 3 years through 20 years.
Please visit the Maryland Department of Health FAQs page for more information
Information current as of: