Oregon Office of Rural Health

Oregon Office of Rural Health

Implementing Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit in Oregon

Effective January 1, 2023, Oregon will implement the full Early and Periodic Screening, Diagnosis and Treatment benefit (EPSDT) for children and youth until their 21st birthday. This means both the Open Card program and Coordinated Care Organizations (CCOs) must cover any medically necessary and medically appropriate services (and dentally appropriate, for dental services) for enrolled children and youth, regardless of:

  • The location of the diagnosis on the Prioritized List of Health Services
  • Whether it pairs, or is a non-pairing service
  • Whether it is a previously “non-covered” ancillary service.
  • Whether it is covered under the State Plan.

Contact: Laura Sisulak (Laura.Sisulak@dhsoha.state.or.us).

Provider education (no-cost):

  • Audience: Clinicians and practice managers serving children and youth that are Oregon Health Plan members.
  • Presenters will include the following OHA clinician leaders: Dana Hargunani, MD, MPH, OHA Chief Medical Officer; Dawn Mautner, MD, MS, Medicaid Medical Director; Margaret Cary, MD, MPH, OHP Fee For Service Medical Director.
  • Session One: January 24, 2023 from 12:00 - 1:00 pm. Overview of the EPSDT policy change and implementation. Register here: https://www.zoomgov.com/meeting/register/vJItdumorT8oH4rMXC81lzetQsxsfNMiHDg
  • Session Two: February 7, 2023 from 12:00 - 1:00pm. Ensuring EPSDT access - documenting medical necessity, prior authorization and related processes for Open Card patients. Register here: https://www.zoomgov.com/meeting/register/vJItc-Copz8oGIcpxF3BQWwG0ahpIrclYPs
  • Both sessions will be recorded, and webinar materials will be made available in Spanish.
  • Please contact Tom Cogswell (thomas.cogswell@dhsoha.state.or.us, 971-304-9642) if you need an accommodation to fully participate in these webinars. Examples of accommodations include American Sign Language (ASL) or language interpretation, and closed captioning.

Additional information may be found at: www.oregon.gov/EPSDT , including: