The Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) service is Medicaid's comprehensive preventive child health service (medical, dental, and case management) for individuals from birth through 20 years of age. EPSDT was created by the 1967 amendments to the federal Social Security Act and defined by the Omnibus Budget Reconciliation Act (OBRA) of 1989. In Texas, EPSDT is known as Texas Health Steps, which includes the preventive care components, or Early and Periodic Screening (EPS), of the total EPSDT service. In addition, medically necessary health-care services listed in the Act are provided to children and adolescents enrolled in Texas Health Steps even if the service is not available under the state’s Medicaid plan to the rest of the Medicaid population. In Texas, these additional services are available through the Comprehensive Care Program (CCP).
The Texas Medical Assistance (Medicaid) Program was implemented September 1, 1967, under the provisions of Title XIX of the Federal Social Security Act and Chapter 23 of the Texas Human Resources Code. The cost of Medicaid is shared by the State of Texas and the federal government. The Texas Health and Human Services Commission (HHSC), the single state Medicaid agency, is responsible for the Title XIX Program. The administration of the program is accomplished through contracts and agreements with medical providers, claims administrators (claims reimbursement processor), enrollment brokers, various managed care organizations, and state agencies including the Department of Assistive and Rehabilitative Services (DARS), and Department of State Health Services (DSHS). Medicaid providers, including those providing Texas Health Steps services, are reimbursed for their services through contracts with health-insuring contractors, fiscal agents, or direct vendor payments.