CHCUP (Child Health
Check-up) is a Medicaid child health program of early and periodic screening,
diagnosis and treatment services for beneficiaries under the age of 21. It used
to be called EPSDT. All children of these ages who are SHP members should
receive these examinations, including the required focus areas. The program
ensures access to necessary health resources and assists parents and guardians
in appropriately using those resources.
PCPs receive a list of eligible members at the beginning of each month who have
chosen or been assigned to the PCP as of that date. It is the responsibility of
the provider to contact members and encourage the member, or legal guardian, to
be seen for the CHCUP. Each time a provider performs a CHCUP screening, the
provider must submit an encounter form using the appropriate CPT and ICD codes.
The program provides for regular health check-ups that include:
* A comprehensive health and developmental history (including assessment of
behavioral health status)
* A comprehensive physical exam
* Nutritional and developmental assessment
* Vision, hearing and dental screenings
* Lab tests, including testing for lead poisoning
* Appropriate immunizations
* Health education/anticipatory guidance
* Diagnosis and treatment
* Referral and follow-up, as needed
* Referral to a dentist begins at 3 years of age or earlier as medically
necessary, with subsequent examinations by a dentist every 6 months, or more frequently as
prescribed by a dentist or other authorized provider
