Medicaid EPSDT Benefit
The Medicaid EPSDT (Early, Periodic, Screening, Diagnostic, Treatment) benefit provides preventive and comprehensive health care services for children under age 21 who are enrolled in Medicaid. EPSDT ensures that children, up through age twenty, receive appropriate medically necessary care including preventive and corrective developmental, and specialty services. This includes autism treatment benefits such as Applied Behavior Analysis (ABA) therapy for those children for whom it is medically necessary.
It is the job of each state to make sure the full range of EPSDT services is available. Each state must also make sure that families of enrolled children are aware of and have access to those services that are medically necessary for their child. In Indiana, About Special Kids (A.S.K.), the Autism Society of Indiana (ASI), Family Voices Indiana, the Indiana Resource Center for Autism (IRCA) and The Arc of Indiana are working together to provide this information to families.
This announcement and the accompanying FAQ (Frequently Asked Questions) is offered by these five organizations to help inform and support families. Please share this information with all families who might benefit.
Medicaid EPSDT Autism Coverage Collaborative Letter
FAQ About Medicaid Coverage for Autism Treatment 4.18.16