Early and Periodic Screening, Diagnosis and Treatment (EPSDT) is a federally mandated Medicaid program for children. In Kentucky, it is divided into two components: EPSDT Screenings (see below) and EPSDT Special Services.
The EPSDT Screening Program provides routine physicals or well-child check ups for Medicaid eligible children at certain specified ages. It is considered preventive care. Children are checked for medical problems early. Specific tests and treatments are recommended as children grow older.
The areas of health care that are checked include: preventive check-ups; growth and development assessments; vision; hearing; teeth; immunizations; and laboratory tests.
Children should receive health check-ups regularly or before the following ages: 1 month; 2 months; 4 months; 6 months; 9 months; 12 months; 15 months; 18 months; 24 months; 30 months; 3 years; 4 years; 5 years; 6 years; 8 years; and once a year for ages 6-20.
For more information, refer to the American Academy of Pediatrics Periodicity Schedule.
If your child in enrolled with a Managed Care Organization (MCO), you may contact them at:
If your child has Medicaid and you need assistance with transportation, or for more information, contact (800) 635-2570.
Any Medicaid eligible child is eligible for EPSDT screenings. Additionally, any Medicaid eligible child may receive EPSDT Special Services as long as the services are medically necessary and not covered in another Medicaid program area.
EPSDT Special Services may only be provided to individuals under age 21.
Services may be provided through the last day of the month in which the individual turns 21. For example, if someone is receiving services through the EPSDT Special Services Program, and their 21st birthday is March 16, they may continue to receive services through EPSDT Special Services through March 31 (if they are still eligible for Medicaid.)
If you questions, please contact Member Services at (800) 635-2570
How do I verify eligibility?
Once eligibility has been obtained, you may verify continued eligibility by one of the following methods:
- by contacting the Automated Voice Response System at (800) 807-1301,
- by using the Web-based KYHealth-Net System
Provider Contact information
- For billing questions, contact DXC at (800) 807-1232 or visit the website
- For provider questions, contact the Provider Services Call Center at (855) 824 5615
- For provider enrollment or revalidation questions, contact Provider Enrollment at (877) 838-5085
- For KyHealth-net assistance, email DXC
- To report fraud and abuse, contact Fraud Hotline at (502) 564-2348
- For pharmacy questions, contact Pharmacy Support Center at (800) 432-7005
- For pharmacy prior authorization questions, contact Pharmacy Prior Authorization at (800) 477-3071