Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.05-017 - Child Health Services/Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Update #63

See section 212.000 for EPSDT screening terminology.

An EPSDT periodic complete medical screen includes both hearing and vision screens. Providers must not bill an EPSDT periodic or Interperiodic vision or hearing screen on the same day or within 7 days of an EPSDT complete medical screen by the same or different providers. The above billing combinations represent a duplication of services.

An EPSDT interperiodic full medical screen includes both hearing and vision screens. Providers must not bill an EPSDT periodic or Interperiodic vision screen on the same day or within 7 days of an EPSDT Interperiodic full medical screen by the same or different providers. The above billing combinations represent a duplication of services.

Claims for EPSDT medical screenings must be billed electronically or using the DMS-694 EPSDT paper claim form. View or print a DMS-694 sample claim form.

1 Exempt from PCP referral requirements

2 Covered when specimen is referred to an independent lab

Immunizations and laboratory tests may be billed separately from comprehensive screens.

The verbal assessment of lead toxicity risk is part of the complete CHS/EPSDT screen. The cost for the administration of the risk assessment is included in the fee for the complete screen.

Laboratory/X-ray and immunizations associated with an EPSDT screen may be billed on the DMS-694 EPSDT claim form.

When billing on paper, the EPSDT screening services must be billed with a type of service code "6."

For billing on paper, immunizations must be billed with a type of service code "1."