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EPSDT/Bright Futures

Early and Periodic Screening and Diagnostic Treatment (EPSDT)

EPSDT is a valuable component of patient care for children under 21. Routine visits can identify potential medical concerns and also help develop the important relationships between children, their caregivers and the primary care provider (PCP).

The Pennsylvania Department of Human Services (DHS) requires all Medical Assistance providers to perform screenings that meet national standards recognized by the American Academy of Pediatrics (AAP). Refer to the recent DHS bulletins for the latest updates:

Refer to the current EPSDT Periodicity Schedule and Coding Matrix for guidelines.

Bright Futures (CHIP)

The Bright Futures/American Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the “periodicity schedule.” It includes:

  • Prevention: Scheduled immunizations; dentist visit at the first sign of a tooth and to establish a dental home at no later than 12 months of age; regular oral checkups (two each year), teeth cleanings, fluoride treatments and overall oral health.
  • Growth and Development: Tracking how much a child has grown and developed in the time since their last visit; discussing the child’s milestones, social behaviors and learning with parents/guardians.
  • Identify Concerns: Well-child visits are an opportunity to speak with parents about a wide variety of issues, including developmental, behavioral, sleeping, eating and relationships with other family members.
  • Sick Visits: Determine if the condition, illness or injury that led to the sick visit impedes with the ability to complete a well-child visit and that the child is eligible for a well-child visit.

Providers are encouraged to download the complete Recommendations for Preventive Pediatric Health Care guidelines or go directly to the APA Bright Futures website.

Well-Child Visits

During a well-child visit, please document the following to assure all components of a well-child exam are met:

  • A health history
  • A physical development history
  • A mental development history
  • A physical exam
  • Health education and anticipatory guidance

For weight assessment and counseling for nutrition and physical activity, please document the following:

  • Weight assessment
    • BMI percentile or BMI plotted on a growth chart for children age 3 to 16 years
    • BMI percentile or BMI value for adolescents ages 16 to 17 years
  • Nutrition counseling
    • Discussion of nutritional habits
    • Checklist indicating nutrition was discussed
    • Referral for nutritional education
    • Anticipatory guidance for nutrition
    • Weight or obesity counseling
  • Activity counseling
    • Discussion of physical activity habits
    • Checklist indicating physical activity was discussed
    • Referral for physical activity
    • Anticipatory guidance for physical activity
    • Documentation that information on physical activity was provided to patient and/or their family
    • Weight or obesity counseling

Childhood and Adolescent Immunizations

Please educate families about the need for immunizations. Providers may refer to our Preventive Care Guidelines or the resources listed below for additional information.