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This document outlines the procedures and assessments required for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) exam for infants in New Jersey. It includes sections for patient information, health history, development milestones, and immunization records, along with a treatment plan and referrals.
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How to fill out early and periodic screening

How to fill out early and periodic screening
01
Review the eligibility criteria for early and periodic screening.
02
Gather necessary information such as the child's personal details and medical history.
03
Complete the required forms, ensuring all sections are filled out accurately.
04
Submit the completed forms to the appropriate health care provider or agency.
05
Schedule an appointment for the screening.
06
Prepare the child for the screening by discussing what will happen.
07
Attend the screening appointment.
Who needs early and periodic screening?
01
Children under the age of 21 who are enrolled in Medicaid.
02
Children who may have developmental delays or concerns.
03
Families seeking preventive health care services for their children.
04
Children in at-risk categories due to socio-economic factors.
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What is early and periodic screening?
Early and periodic screening refers to a program designed to provide comprehensive health assessments to children to identify any potential physical, mental, or developmental issues early on.
Who is required to file early and periodic screening?
States are required to provide early and periodic screening services under the Medicaid program, and parents or guardians of eligible children are responsible for utilizing this service.
How to fill out early and periodic screening?
To fill out early and periodic screening, parents or guardians should complete the necessary forms through their state's Medicaid program, ensuring all relevant information about the child's health history and needs are included.
What is the purpose of early and periodic screening?
The purpose of early and periodic screening is to identify health issues early to provide timely interventions and services, thus improving health outcomes for children.
What information must be reported on early and periodic screening?
Information that must be reported includes the child's medical history, physical examination findings, developmental milestones, and any referrals for further evaluation or treatment.
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