Mississippi Administrative Code, Title 23, Part 213, Rule 3.11 provides “[t]he Division of Medicaid pays for all medically necessary services for EPSDT-eligible beneficiaries in accordance with Part 223 of Title 23, without regard to service limitations and with prior authorization.”
Mississippi Administrative Code, Title 23, Part 223, Rule 1.7 (Diagnostic and Treatment Program Services) provides that “EPSDT diagnostic and treatment services consist of all medically necessary services needed to correct or ameliorate physical or mental illnesses and conditions discovered by a screening, whether or not such services are covered under the State Plan; and for a Medicaid eligible child or youth under age twenty-one (21) years, if the service is determined by the Division of Medicaid or its representative to be medically necessary.”
The EPSDT program was expanded in the Omnibus Budget Reconciliation Act of 1989 to allow for additional services to be offered such as:
- adolescent counseling services
- additional treatments and services that may be needed (such as additional office visits, prescriptions and therapy services)
- inpatient hospital
- outpatient hospital services
- physician services
- dental services
- home health services
- durable medical equipment/prosthetics
- private duty nursing
- therapy services (physical, occupational, speech, hearing and language)
- prescription drugs
- podiatry services
- optometry services
- eyeglasses/Contacts
- hearing services
- mental health services
