The OHCA requires that physicians providing reimbursable EPSDT Screens adopt and utilize the version of the Oklahoma Health Care Authority EPDST Periodicity schedule.  Providers are allowed and encouraged to provide optional screenings as indicated and/or as recommended in the guidelines established by the American Academy of Pediatrics.  Optional screenings may be completed at one week, fifteen months, and eleven, thirteen, fifteen, seventeen and nineteen years of age.  At a minimum, practitioners are required to perform the OHCA recommended elements for each age related visit as follows:

• (1) Each EPSDT visit whether optional or required will consist, at a minimum, of a history of occurrences since the last screening visit (Health History), measurements of height, weight and head circumference (as appropriate through age two), an age appropriate developmental and a behavioral screening as well as a complete unclothed physical exam.  Immunizations are to be checked and provided as needed according to the Advisory Committee on Immunization Practices (ACIP) schedule and any appropriate laboratory testing should be performed.  Additionally, age appropriate anticipatory guidance is also required to be given to parents in the areas of injury prevention, violence prevention, sleep positioning (through 6 months of age), and nutritional counseling.  Beginning at age 4 and with each subsequent visit, a Body Mass Index (BMI) is to be calculated and charted.  A tuberculin test is required to be given to any at risk child from the ages of 12 months to age 20 years and a cholesterol screening is required to be given to at risk children between the ages of 2 years and 20 years.  Beginning at age 12, at risk female children should also be given a pelvic exam and all at risk children should be given STD screening.  Dental screens begin at the first sign of tooth eruption by the primary care provider and with each subsequent visit to determine if the children needs a referral to a dental provider.  In addition to the elements listed above, each compensable EPSDT visit also requires the following as designated by age:
• (2) Newborn visit.  The newborn visit occurs inpatient.  The visit consists, at a minimum, of a prenatal history and physical examination of all body systems.  The practitioner also conducts a screening of vision that consists of an assessment of the anatomy of the lids, alignment of the eyes and clarity of the ocular media with particular attention to documenting the presence of a normal red reflex.  A newborn hearing screen is required.  The Heb B Immunizations is required.  A Hereditary/Metabolic Screening is required between birth and one month.
• (3) One week visit.  One week visit occurs approximately one week from the hospital discharge date.  A hearing screen is required to be done if the child failed the newborn hearing screen or if there are parental concerns or any other indicator of potential problems.  A Hereditary/Metabolic Screening is required between birth and one month.  This is an optional visit for infants who were discharged early or have other health concerns.
• (4) By one month old visit.  The practitioner conducts a screening of vision that consists of a Red reflex and external appearance exam.  A hearing screen is required if there are parental concerns or any other indicator of potential problems. A Hereditary/Metabolic Screening is required between birth and one month.
• (5) Two month old visit.  The practitioner conducts a screening of vision that consists of a Red reflex and external appearance exam.  A hearing screen is required if there are parental concerns or any other indicator of potential problems.
• (6) Four month old visit.  The practitioner conducts a screening of vision that consists of a Red reflex and external appearance exam.  A hearing screen is required if there are parental concerns or any other indicator of potential problems.
• (7) Six month old visit.  The practitioner conducts a screening of vision that consists of a Red reflex and external appearance exam and evaluation of ocular alignment with a corneal light reflex test.  A hearing screen is required to be done if there are parental concerns or any other indicator of potential problems.
• (8) Nine month old visit.  The practitioner conducts a screening of vision between the ages of nine and twelve months (if the vision screening is done at this visit, it need not be repeated at the twelve month visit) that consists of a Red reflex and external appearance exam and evaluation of ocular alignment with a corneal light reflex test.  A hearing screen is required to be done if there are parental concerns or any other indicator of potential problems.  A blood lead test may be provided as early as nine months but is required at 12 and 24 months.  A hematocrit or hemoglobin test is required to be performed between the ages of nine months and three years.
• (9) One year old visit.  The practitioner conducts a screening of vision between the ages of nine and twelve months (if the vision screening was deferred at the nine month visit, it must be provided at the twelve month visit) that consists of a Red reflex and external appearance exam and evaluation of ocular alignment with a corneal light reflex test.  A hearing screen is required to be done if there are parental concerns or any other indicator of potential problems.  A blood lead test may be provided as early as nine months but is required at 12 and 24 months.  A hematocrit or hemoglobin test is required to be performed between the ages of nine months and three years and a tuberculin test is required to be given to any at risk child from the ages of 12 months to age 20 years.
• (10) Fifteen month old visit.  A hearing screen is required to be done if there are parental concerns or any other indicator of potential problems.  A hematocrit or hemoglobin test is required to be performed between the ages of nine months and three years. A tuberculin test is required to be given to any at risk child from the ages of 12 months to age 20 years.  This is an optional visit.
• (11) Eighteen month old visit.  A hearing screen is required to be done if there are parental concerns or any other indicator of potential problems.  A hematocrit or hemoglobin test is required to be performed between the ages of nine months and three years. A tuberculin test is required to be given to any at risk child from the ages of 12 months to age 20 years.
• (12) Two years old visit.  A hearing screen should be done if there are parental concerns or any other indicator of potential problems.  A blood lead test may be provided as early as nine months but is required at 12 and 24 months.  A hematocrit or hemoglobin test is required to be performed between the ages of nine months and three years.
• (13) Three years old visit.  The practitioner conducts one vision screening between the ages three to five.  The screening consists of an alignment and an acuity test e.g., Allen Cards, Snellen chart or HOTV Test in each eye.  A hearing screen, subjective by history, is done if there are parental concerns or any other indicator of potential problems.  A hematocrit or hemoglobin test is required to be performed between the ages of nine months and three years.
• (14) Four years old visit.  The practitioner conducts one vision screening between the ages three to five.  The screening consists of an alignment and an acuity test e.g., Allen Cards, Snellen chart or HOTV Test in each eye.  A hearing screen should be done.
• (15) Five years old visit.  The practitioner conducts one vision screening between the ages three to five.  The screening consists of an alignment and an acuity test e.g., Allen Cards, Snellen chart or HOTV Test in each eye.  A hearing screen is required to be done if the screening was not provided in the school.
• (16) Six years old visit.  The practitioner conducts a screening of vision that consists of visual acuity testing.  An objective hearing screen is required if the screening was not provided in the school.
• (17) Eight years old visit.  The practitioner conducts a screening of vision that consists of visual acuity testing.  An objective hearing screen is required if the screening was not provided in the school.
• (18) Ten years old visit.  The practitioner conducts a screening of vision that consists of visual acuity testing.  An objective hearing screen should be done if the screening was not provided in the school.
• (19) Eleven and thirteen years old visit.  The practitioner conducts one screening of vision that consists of visual acuity testing between the ages of 11 through 18.  Hearing screens are subjective by history.  A  hematocrit or hemoglobin test and a urinalysis test are required to be done once from ages 11 through age 20 on menstruating females.  These visits are optional visits.
• (20) Twelve years old visit.  The practitioner conducts one screening of vision that consists of visual acuity testing between the ages of 11 through 18 (all other years are subjective by history).  Hearing screens are subjective by history.  A hematocrit or hemoglobin test and a urinalysis test are required to be done once from ages 11 through age 20 on menstruating females.
• (21) Fourteen, sixteen, eighteen, and twenty years old visit. The practitioner conducts one screening of vision that consists of visual acuity testing between the ages of 11 through 18.  Hearing screenings are subjective by history.
• (22) Fifteen, seventeen and nineteen years old visit.  The practitioner conducts one vision screening that consists of visual acuity testing between the ages of 11 through 18.  Hearing screenings are subjective by history.  These are all optional visits.