Early Periodic Screening Diagnosis Testing – EPSDT

EPSDT Personal Care Services

ELIGIBILITY:

All Medicaid recipients 0 to 21 not receiving individual Family Support waiver services. However, once a recipient receiving Indiviual Family Supportn waiver services has exhausted those services they are then eligible for EPSDT Personal Care Services.

Recipients of Children’s Choice Waiver care receive both PCS and Family Support Services on the same day; however, the services may not be rendered at the same time.

COVERED SERVICES:

  • Basic personal care-toileting & grooming activities.
  • Assistance with bladder and/or bowel requirements or problems.
  • Assistance with eating and food preparation.
  • Performance of incidental husehold chores, only for the recipient.
  • Acompanying, not transporting, recipient to medical appointments.
  • Does NOT cover any medical tasks such as medication tasks such as medication administration, tube feedings.

COMMENTS:

The Personal Care Agency must submit the Prior Authorization request.

Recipients receiving Support Coordination (Case Management Services) must also have their PCS Prior Authorization by unisys.

PCS is not subject to service limits. Units approved will be based on medical necessity and the need for covered services.

Recipients receiving Personal Care Services must have physician’s prescription and meet medical criteria.

Does not include medical tasks.

Provided by licensed providers enrolled in Medicaid to provide Personal Care Attendant services.