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Wiki EPSDT questions

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FDRAPER

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Is anyone familar with these questions during a Medicaid wellchild visit:

Well Child Care
EPSDT Referral Given? YesNo
EPSDT Referral Reason Available - Not UsedNot UsedUnder TreatmentNew Services Requested
EPSDT Referral Reason Available - Not UsedNot UsedUnder TreatmentNew Services Requested
EPSDT Referral Reason Available - Not UsedNot UsedUnder TreatmentNew Services Requested


Are these services the result of an EPSDT referral? YesNo

Is this something that clinical staff needs to enter in EMR while with patient? From the billing prospective I had no idea what the acronym even stood for until I googled it.
 
Is your practice a participant in the Vaccines for Children Program through Medicaid? EPSDT is usually done on the billing side - if you're billing a wellchild visit only (9939X) the answer is no. If you're billing a additional "sick visit" (99212) the answer is yes. If you'll pull the Health Check billing manual on the Medicaid website, you'll find step by step instructions for billing Health checks - whether you participate in the VFC Program or not. Good luck!
 
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