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Early and Periodic Screening, Diagnostic and Treatment is a federal Medicaid benefit for children and young adults under age 21 that requires states to provide comprehensive health care services. EPSDT is one of the most powerful but underutilized tools in disability services. Under EPSDT, states must cover any medically necessary service that falls within the federal Medicaid categories — even if the state does not normally cover that service in its Medicaid plan. This includes ABA therapy, speech therapy, occupational therapy, mental health services, assistive technology, personal care, private-duty nursing, and durable medical equipment. The 'periodic' component requires regular developmental screenings, and the 'diagnostic' component requires follow-up evaluation when a screen identifies a concern.
EPSDT is a legal mandate that can override state Medicaid limitations for children under 21. If your state denies a service your child needs, EPSDT may require them to cover it. This is a powerful tool for appeals.