EPSDT — Medicaid’s Mandate for Children and Adolescents

This article reviews the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit under Medicaid, reaffirmed by CMS in 2024 following a congressional directive. EPSDT ensures comprehensive medical, dental, vision, and behavioral health coverage for children and adolescents under 21, including services to identify and treat health conditions early. Despite its broad guarantees, gaps in implementation persist due to inconsistent state oversight, limited awareness among providers and families, and delegation to inadequately equipped managed-care organizations. The authors argue for heightened awareness, improved enforcement, and stronger infrastructure to deliver on EPSDT’s promise and address current U.S. health system challenges affecting children’s long-term outcomes

This article reviews the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit under Medicaid, reaffirmed by CMS in 2024 following a congressional directive. EPSDT ensures comprehensive medical, dental, vision, and behavioral health coverage for children and adolescents under 21, including services to identify and treat health conditions early. Despite its broad guarantees, gaps in implementation persist due to inconsistent state oversight, limited awareness among providers and families, and delegation to inadequately equipped managed-care organizations. The authors argue for heightened awareness, improved enforcement, and stronger infrastructure to deliver on EPSDT’s promise and address current U.S. health system challenges affecting children’s long-term outcomes