MedicaidAdministrativeMedium impact
See Our New EPSDT Clinical Practice and Billing Guideline
BCBS Illinois·IL · Pediatrics, Family Medicine, General Practice +2 more·Medical Policy
Effective date
Feb 17, 2026
We identified it
Jun 16, 2026
Summary
A new EPSDT (Early and Periodic Screening, Diagnostic and Treatment) clinical practice and billing guideline has been released for Medicaid services for patients under age 21. This guideline standardizes preventive care, screenings, diagnostic and treatment services to improve health outcomes for young Medicaid members.
Action Required
Review the new EPSDT clinical practice and billing guideline available on the BCBS Illinois website. Billing team and providers should familiarize themselves with standardized care requirements for Medicaid members under age 21 receiving preventive health, dental, mental health, developmental and specialty services. Contact the Quality Improvement Department with questions about EPSDT services or billing requirements.