Update to the EPSDT Periodicity Schedule

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TO: All Early, Periodic, Screening, Diagnosis and Treatment (EPSDT) Providers

RE: Update to the EPSDT Periodicity Schedule

Effective for dates of service on or after October 1, 2025 (Fiscal Year 2026), the Alabama Medicaid Agency (Medicaid) is updating the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) periodicity schedule to include changes such as inclusion of well-child visits at 3-5 days and 30 months of age; and hearing, vision and developmental screenings. These updates align with the American Academy of Pediatrics' Bright Futures guidelines.

The updated EPSDT periodicity schedule includes the following visits:

Providers should use appropriate Evaluation and Management (E&M) codes (e.g., 99381-99385, and 99391-99395 for preventative services) and include the EP modifier for EPSDT screenings. Refer to the updated EPSDT Periodicity Schedule in the October 2025 Provider Billing Manual, Appendix A (Well-Child Visit/EPSDT) at www.medicaid.alabama.gov for full details, including required components such as physical exams, immunizations, vision/hearing screenings and developmental assessments.

Providers are encouraged to educate families on the importance of adhering to the schedule and to submit referrals using the updated EPSDT Referral Form 362 for any identified needs.

Other updates to the periodicity schedule include changes to protocols for lead toxicity and tuberculosis (TB) to align with current guidelines from the Centers for Disease Control and Prevention (CDC) and enhance early detection and intervention for at-risk children. For questions on testing or interpretation, consult the CDC's TB resources or call the Alabama Department of Public Health TB Control Program at (334) 206-5330.

Providers should refer to Appendix A - Well Child Visits (EPSDT) for further information and updates. For billing questions, contact the Provider Assistance Center at (800) 688-7989.