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Early Periodic Screening Diagnosis Treatment (EPSDT)

Effective January 1, 2023, Oregon will implement the full Early and Periodic Screening, Diagnosis and Treatment benefit (EPSDT) for children and youth until their 21st birthday. This means both the Open Card program and coordinated care organizations (CCOs) must cover any medically necessary and medically appropriate services (and dentally appropriate, for dental services) for enrolled children and youth, regardless of:

  • The location of the diagnosis on the Prioritized List of Health Services;
  • Whether it pairs, or is a non-pairing service;
  • Whether it is a previously “non-covered” ancillary service; or
  • Whether it is covered under the State Plan.

Provider education (no-cost):

  • Audience: Clinicians and practice managers serving children and youth who are Oregon Health Plan members.
  • Presenters will include the following OHA clinician leaders: Dana Hargunani, MD, MPH, OHA Chief Medical Officer; Dawn Mautner, MD, MS, Medicaid Medical Director; Margaret Cary, MD, MPH, OHP Fee-For-Service Medical Director.
  • Session Title: Recorded on February 7, Noon–1 p.m. Ensuring EPSDT access — documenting medical necessity, prior authorization and related processes for Open Card patients. Watch the recording here: https://youtu.be/aJ6HpBoVdjk
  • Please contact Tom Cogswell (Cogswell@dhsoha.state.or.us, 971-304-9642) if you need an accommodation to fully participate in these webinars. Examples of accommodations include American Sign Language (ASL) or language interpretation, and closed captioning.

Additional information may be found at: www.oregon.gov/EPSDT, including: