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
Eligible children and young adults should have health check-ups at:
Birth
2 – 4 days for newborns discharged in less than 48 hours after delivery
By 1 month , 2 months, 4 months, 6 months, and 9 months
12 months,15 months, and 18 months
Once every year for ages 2 – 20 years
Individuals may also request a Child Health Check-Up at other times if they think their child needs it
