1. (1) The Agency will establish a distinct periodicity schedule for screening services, after consultation with recognized medical organizations involved in child health care. This schedule will be published in the Provider Billing Manual.
2. (2) Periodic screening services will be provided at intervals that meet reasonable standards of medical practice in accordance with those described for well-child care by Bright Futures and American Academy of Pediatrics.
3. (3) Interperiodic screenings are covered when medically necessary to determine the existence of suspected physical or mental illnesses or conditions.
4. (4) An EPSDT Intensive Developmental Diagnostic Assessment is a multidisciplinary comprehensive screening limited to infants 0 to under two years of age, and is also limited to two per recipient per lifetime. These screenings are in addition to the routine periodic screenings and must be performed by a qualified EPSDT Intensive Developmental Diagnostic Assessment Screening provider, as approved and enrolled by Medicaid.

Author: Kristi Segrest, Associate Director, Dental, EPSDT, and Physicians Program

Statutory Authority: Title XIX, Social Security Act; State Plan; 42 C.F.R. §441.50; OBRA '89 §6403.

History: Rule effective October 1, 1982. Amended: Effective July 9, 1984; June 8, 1985. Emergency rule effective October 1, 1986. Amended: Effective October 11, 1986. Emergency rule effective December 1, 1986. Amended: Effective March 12, 1987. Emergency rule effective November 7, 1988; October 1, 1989; October 1, 1990. Amended: Effective February 13, 1991; January 13, 1993. Amended: Published March 31, 2026; effective May 15, 2026.