Medi-Cal for Kids & Teens (Early and Periodic Screening, Diagnostic, and Treatment [EPSDT] services)

Anthem Blue Cross and EPSDT services

Anthem Blue Cross (Anthem) is committed to ensuring members receive age-appropriate preventive health services. A list of panel members who, based on our claims data, may not have received Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services according to schedule is sent to PCPs. Additionally, we mail information to these members encouraging them to contact their PCP’s office to set up appointments for needed services.

Please note, specific service(s) needed for each member is reported on the list. The list is based only on services received during the time the member has been enrolled with us. The list is generated based on claims data received prior to the date printed on the list. In some instances, the appropriate services may have been provided after the report run date. To ensure accuracy in tracking appointments for preventive services, please submit a completed claim form.

Beginning in January 2024, all primary care providers who care for our members under 21 years of age must complete the required DHCS training for Medi-Cal for Kids & Teens (EPSDT) services. Anthem is required to submit an annual plan to DHCS that includes an attestation that our Provider Network is in compliance with the EPSDT Medi-Cal for Kids & Teens training along with a list of all Network Providers who have completed the training within the prior 12 months.   

If you would like more information about Anthem provider resources for EPSDT services and the state of California’s state-sponsored programs, please contact us .