Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
NOTICE - Beginning January 2, 2008 TennCare will require the use of a National Provider Identifier (NPI) number on all claims submitted to TennCare's Managed Care Organizations. MCO claims submitted without an NPI will be denied and must be resubmitted with an NPI before an MCO can pay the claim.
Policy Statement.
Questions concerning the new NPI requirement should be directed to your MCO representative(s).
What is EPSDT?EPSDT is a federal requirement for all Medicaid programs related to early identification and treatment of health care conditions for children. In Tennessee, EPSDT is called TENNderCare. For more information see "
State and Federal Requirements".
Components of EPSDT/TENNderCARE exams include:
- Comprehensive Health (Physical and Mental) and Developmental History
- Initial and Interval History
- Developmental/Behavioral Assessment
- Comprehensive Unclothed Physical Exam
- Vision Screening
- Hearing Screening
- Laboratory Tests
- Immunizations
- Health Education/ Anticipatory Guidance
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TNAAP can help you:
- Improve the quality of preventive health screens you perform
- Maximize reimbursement
- Reduce administrative costs
- Improve audit outcomes
Use our resource and reference materials:
- Free EPSDT training programs (formal or informal) at your practice
- Downloadable age-specific chart documentation forms
- Other sample forms such as lead and TB risk assessment forms
- A comprehensive EPSDT manual with detail regarding:
- Requirements of each component
- Dental referrals
- State audit standards
- Reporting fraud and abuse
- Filing a medical appeal with an MCO
- Information and resources regarding Developmental and Behavioral screening
Many of our Forms and Documents on this website are in .pdf file format, you will need Adobe Acrobat Reader to download most of them.

Download Adobe Acrobat Reader for free!
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For more information about EPSDT and our resources contact:
Ruth E. Allen, EPSDT Director
Phone: 865-927-3030 Email: rutheallen@yahoo.com
Janet Smith, RHIT, CPC Coding Educator
Phone: 615-654-0301 Email: janettnaap@comcast.net
Deborah O. Usry, M.Ed Developmental Services Coordinator
Phone: 615-376-4829 Email: dusrytnaap@comcast.net
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