Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program for Children and Youth – New Provider Resources Available

Aug 12, 2024

MaineCare’s EPSDT program allows MaineCare members under the age of 21 to receive medically necessary services that are not typically covered due to limits on the type, frequency, or duration of the service. These services can include preventive, dental, developmental, behavioral health, and specialty services.

Comprehensive EPSDT program resources are now available for providers:

• The MaineCare Children’s Services webpage now provides information regarding all aspects of MaineCare’s EPSDT Program including service criteria, the prior authorization (PA) request process and billing guidance for EPSDT approved services. In addition, there are various new resources available on the webpage including a fact sheet for providers and their staff, a member fact sheet that can be given to MaineCare members to help explain the EPSDT benefit, and a preventative health screening tools list, among others.

• There is also a new EPSDT for Children and Youth interactive provider learning module. The module provides an overview and walks providers through key components of the program. This is a great educational tool to help MaineCare providers and their staff become familiar with the EPSDT benefit and how it can help MaineCare members under 21. After completing the learning module, a certificate of completion is available upon request.

We hope providers find these new EPSDT resources helpful and we welcome feedback.

For further information about the EPSDT Program or to provide feedback, please contact Becky Parsons, EPSDT Program Coordinator.