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Are any child find activities and initial evaluations covered under the Medicaid Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit?

Yes, some child find activities could be covered in Medicaid. Child find activities may involve a formal screening process to determine whether the child should be referred for an evaluation to determine whether a child has a disability and the nature and extent of the special education and related services that the child needs. In a scenario where a child is enrolled in Medicaid, a screening or initial evaluation could be coverable under a 1905(a) benefit category. As specified in section 1905(r)(5) of the Act, EPSDT entitles most eligible Medicaid-enrolled children and adolescents to services and treatments that fit within any of the benefit categories of Medicaid-coverable services listed in section 1905(a) of the Act if medically necessary, as determined by the State, to “correct or ameliorate” identified conditions. For a child who is not yet enrolled in Medicaid, the child find activities such as screenings and evaluations would not be covered.


More on Child Find is available at the Department of Education’s website
 

Date
FAQ ID
166401
FAQ Question
Are any child find activities and initial evaluations covered under the Medicaid Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit?