Measuring Preventive Health Performance A Primer for Child Advocates on the Medicaid EPSDT Reporting Form

Executive Summary

Since 1990, state Medicaid programs have been required to use a uniform reporting form to report on their Early and Periodic Screening, Diagnosis and Treatment programs (EPSDT), Medicaid’s mandatory benefit for children and youth under age 21, using a uniform reporting form. The Form is commonly called the “Form 416,” and it can play an important role in policy-based advocacy to improve children’s health.
This primer provides background on the requirements for EPSDT and EPSDT reporting, explains the revisions to the 416 Form, and suggests ways that the Form can aid in advocacy efforts.

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