What is EPSDT?
EPSDT is Early and Periodic Screening, Diagnosis and Treatment. People under the age of 21 who are receiving medical benefits may receive health and dental screenings and follow-up treatment for certain conditions. Providers include physicians, health departments, schools and some local health clinics. These exams are available on a periodic schedule based on the ages of the individual.
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Who should get an EPSDT exam?
Every child enrolled in SoonerCare should receive EPSDT services until he or she is 21 years old.
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Where can I get an EPSDT exam?
These services may be offered at a local:
- Medical provider - a doctor, physician assistant or nurse practitioner
- Hospital or health clinic
- Public school
EPSDT school-based services include:
- Child health screenings
- Hearing tests
- Speech therapy
- Physical therapy
- Occupational therapy
- Psychological services
- Nursing services
- Assistive technology
- Personal care services
- Vision screening exams
- Immunizations (only if authorized by the child's medical provider, or if an appointment with the medical provider could not be scheduled)
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When should my child get an EPSDT exam?
Children should get EPSDT exams at regular times even when the child is feeling well.
- Babies grow so fast they need a lot of EPSDT exams. They need exams at:
- Birth to 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- Youngsters need exams at:
- 2 years
- 3 years
- 4 years
- 5 years
- Older Kids and Teenagers need exams:
- Every other year until he or she is 21 years old
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What will an EPSDT exam include?
Your child's medical provider -- a doctor, physician assistant or nurse practitioner -- will give the exam. Whoever performs the exam will check:
- The overall physical condition of your child to see if he or she is growing well
- Ears and eyes
- Diet
- Childhood immunizations (shots)
- Lab tests (if needed)
- Blood lead screening
Blood levels should be checked at:
- 12 months (1 year)
- 24 months (2 years)
- Any age up to 72 months (5 years) if there is no record of past blood level screens.
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What happens if my child needs further services?
If the medical provider finds a health problem during the EPSDT exam, he or she may send you to another provider or place to take care of it.
These 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
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How do I schedule an EPSDT exam?
To make an appointment for an EPSDT exam, call your Soonercare provider. It may take up to three weeks to get an EPSDT exam appointment.
If you have called your SoonerCare provider and are having trouble getting an appointment, call the helpline at 1-800-987-7767. Call 1-800-757-5979 (TDD/TTY) only if you are hearing impaired.
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What if I need a ride to the EPSDT exam appointment?
Call SoonerRide at 1-877-404-4500 from 8 a.m. to 6 p.m. Monday through Saturday. This service will pick you and your children up and take you to the appointment and then drop you off after the appointment. Call 918-584-7209 (TDD/TTY) only if you are hearing impaired.
You will need to call SoonerRide at least three days before your child's appointment to make sure you can get a ride.
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What if I can't keep my child's appointment?
You should always try your best to keep your appointment with your medical provider, but if something happens and you cannot keep it:
- Always call your medical provider's office to cancel the appointment. This way your provider can see other people who need his or her services.
- Call the provider's office as soon as you know you will not be able to keep the appointment.
- Call SoonerRide to cancel if you had arranged to get a ride to or from the appointment.
If you have more questions about EPSDT, please call the SoonerCare Helpline at 1-800-987-7767, Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to noon. Call 1-800-757-5979 (TDD/TTY) only if you are hearing impaired.
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