New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 320 - EARLY AND PERIODIC SCREENING, DIAGNOSIS AND TREATMENT (EPSDT) SERVICES
Part 2 - EARLY AND PERIODIC SCREENING, DIAGNOSIS AND TREATMENT (EPSDT) SERVICES
Section 8.320.2.9 - EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT SERVICES
Universal Citation: 8 NM Admin Code 8.320.2.9
Current through Register Vol. 35, No. 6, March 26, 2024
The medical assistance division (MAD) pays for medically necessary health services including preventive, treatment and ameliorative services for a medical assistance program (MAP) eligible recipient under 21 years of age through the early and periodic screening, diagnostic and treatment (ESPDT) services program. See 42 CFR 441.50 Subpart B.
A. EPSDT description:
(1) early: assessing health care early in
life so that potential disease and disabilities can be prevented or detected in
their preliminary stages, when they are most effectively treated;
(2) periodic: assessing a child's health at
regular recommended intervals in the child's life to assure continued healthy
development;
(3) screening: the use
of tests and procedures to determine if children being examined have conditions
warranting closer medical or dental attention;
(4) diagnostic: the determination of the
nature or cause of conditions identified by the screening; and
(5) treatment: the provision of services
needed to control, correct or lessen health problems.
B. Services provided under EPSDT are accessed following an initial health screening service called the tot to teen healthcheck or health check referral or through other diagnostic evaluations or assessments.
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