EPSDT Special Services (Early and Periodic Screening, Diagnosis and Treatment Special Services) are available for children under the age of 21 with a qualifying medical diagnosis and physician order.
Services available include Physical Therapy, Occupational Therapy, and Speech Therapy.
EPSDT special services help eliminate potential barriers to additional diagnostic testing/screening and treatment to ensure children receive the medically necessary services they need.
Who May Qualify for EPSDT Special Services?
Any Medicaid-eligible child may qualify to receive EPSDT special services as long as the services are medically necessary and are not covered in another Medicaid program area.
Qualifying criteria include, but not limited to:
- Developmental Delay: The child is not reaching age-appropriate milestones in areas such as:
- Cognitive skills
- Communication
- Gross or fine motor skills
- Self-help or daily living skills
- A diagnosis is in place that supports the need for therapy services.
Eligibility for our services is determined through an evaluation conducted by a licensed therapist. This evaluation must be approved by the child’s pediatrician. The determination is based on the child’s diagnosis, medical necessity, availability of therapists, and adherence to program guidelines.
EPSDTss Referrals
Referrals can be made by anyone, including parents, healthcare providers, or school staff. An EPSDTss Coordinator must review the referral to determine eligibility and service availability. Please note that all EPSDT special services require prior authorization and approval from Medicaid or the child’s Managed Care Organization (MCO).
Contact Information
For more information on EPSDT special services, please call 270-686-8123 or toll free 1-800-928-7123 and ask to speak to an EPSDTss Nurse.
EPSDT Special Services operates under the direction of Green River District Home Health.
For Providers
Training materials are available for providers who have contracted with Green River District Health Department and Green River District Home Health to provide EPSDT special services.
Click here to access EPSDTss provider training materials.
