Upstream prevention and early identification of diseases or conditions are powerful strategies to support children to reach their optimal health and to ensure they can thrive as they grow. The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Medicaid benefit plays a crucial role in children’s health and well-being by requiring broad coverage of medically necessary preventive screenings for all Medicaid-eligible children and adolescents under 21. However, overall decision-making processes for screening coverage and implementation within and beyond EPSDT are often unclear to stakeholders and vary by state.
This report can help child health stakeholders better understand opportunities and challenges associated with obtaining Medicaid approval for coverage of pediatric screenings. The report explores key factors that influence state-level decisions to cover screenings. It also offers recommendations for how states can facilitate opportunities for Medicaid stakeholders to help inform pediatric screening coverage decisions and ultimately improve child health and well-being.