Appendix A Well Child Check-Up (EPSDT)

Well Child Check-Up
Intensive Developmental Diagnostic Assessment
An EPSDT Intensive Developmental Diagnostic Assessment is a multidisciplinary
comprehensive screening limited to infants’ age zero to under two years, and is
also limited to two per recipient per lifetime. These screenings are in addition to
the routine periodic screenings and must be performed by a qualified EPSDT
Intensive Developmental Diagnostic Assessment Screening provider, as
approved and enrolled by Medicaid.
NOTE:
Medical necessity is subject to retrospective review by the Alabama
Medicaid Agency. Please refer to Chapter 7, Understanding Your Rights
and Responsibilities as a Provider, for more information.
Interagency Coordination
The State of Alabama, in conjunction with the Interagency Coordinating Council
and the Alabama Department of Rehabilitation Services will implement a system
of services to the eligible population (20 USC Section 1471 et seq, Part H), with
the assistance of agencies, programs, providers, and the families of eligible
infants and toddlers with special needs.
The Alabama Medicaid Agency is one of nine state agencies that hold positions
on the Interagency Coordinating Council. The Early Intervention Law legislates a
statewide system of early intervention services for eligible infants and toddlers
that is comprehensive and coordinated among all disciplines and providers
involved, and encourages the development of a system of service delivery that
includes parents’ participation and input. Services that provide early intervention
are to be coordinated across agency and provider lines.
The definition of a child eligible for early intervention includes infants and toddlers
under age three inclusive, who are either (1) experiencing developmental delay
equal to or greater than 25 percent as measure by appropriate diagnostic
instruments and procedures in one or more of the following areas: cognitive
development, physical development (including vision and hearing),
communication development, social or emotional development, adaptive
development; or (2) they have a diagnosed physical or mental condition which
has a high probability of resulting n developmental delay are eligible for early
intervention services. Early intervention services can include the following:
Audiology
Family training/counseling & home visits
Health
Medical services for diagnostic/evaluation
Nutrition
Psychological services
Special instruction
Service coordination
Occupational therapy
Nursing
Vision services
Physical therapy
Social work
Speech/language pathology
A-26 January 2011