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Medicaid Program - Early Screening and Periodic Diagnostic Treatment – Oklahoma

The EPSDT program is a comprehensive child-health program, designed to provide diagnosis and health care before medical problems become more complex and costly.

Individuals under 21 who are receiving Medicaid may receive health and dental screenings and follow-up treatment for certain conditions. These exams are available on a periodic schedule based on the age of the individual.

Every child enrolled in SoonerCare should receive EPSDT services until he or she is 21 years old. Recommended intervals for EPSDT exams:

·             Infants–Birth, 2 months, 4 months, 6 months, 9 months, and 12 months

·             Toddlers–15 months and 18 months

·             Children–Annually, ages 2-5 years

·             Teens–Every other year until he or she is 21 years old

EPSDT exams check:

·             Ears and eyes

·             Diet

·             Childhood immunizations (shots)

·             Lab tests (if needed)

·             Blood lead screening

If the medical provider finds a health problem during the EPSDT exam, a referral for additional services may include:

·             Hospital stays

·             Health clinic services

·             Lab tests and x-rays

·             Dental care

·             Vision care (including eyeglasses)

·             Hearing services

·             Physical therapy

·             Occupational therapy

·             Speech therapy

·             Medicines

·             Medical equipment

·             Counseling

·             Personal care services

An initial EPSDT screening may be requested by an eligible individual at any time and must be provided whether the individual’s age coincides with the recommended schedule of visits.

Appointments for an EPSDT exam are made through the SoonerCare provider. It may take up to 3 weeks to get an EPSDT exam appointment. Providers include physicians, health departments, schools and some local health clinics

A Helpline [1-800-987-7767; 1-800-757-5979 TDD/TTY] is available for those who have difficulty scheduling an appointment.

For more information, see:

http://204.87.68.21/medapp/epsdt.htm

Also see:

Medicaid Program - Eligibility - Oklahoma

SoonerCare - Overview - Oklahoma

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