Medicaid Child Health Check-Up

The Child Health Check-Up program is a preventive and comprehensive service for eligible children birth through 20 years of age and for children in the Medicaid program.

Good health starts with regular check-ups! Regular check-ups help to identify health problems before they become serious. Florida Medicaid follows the Bright Futures/American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care. You can view the recommendations by clicking on the following link https://www.aap.org/en-us/Documents/periodicity_schedule.pdf.

Is it time for your child’s check-up? Call your child's doctor today to schedule an appointment.

Available Services:	Eligible children and young adults should have a health check-up at:
Regular physical exams Growth Measurements Immunizations (shots) Vision and hearing screenings Dental Screenings Other important tests and services Referral for diagnosis and treatment, if necessary	birth; 3-5 days for newborns discharged in less than 48 hours after delivery; by 1 month; 2 months; 4 months; 6 months; 9 months; 12 months; 15 months; 18 months; 24 months; 30 months; once every year for ages 3-20. You may also request a Child Health Check-Up at other times if you think your child needs it.

Available Services:

Eligible children and young adults should have a health check-up at:

Regular physical exams
Growth Measurements
Immunizations (shots)
Vision and hearing screenings
Dental Screenings
Other important tests and services
Referral for diagnosis and treatment, if necessary

birth;
3-5 days for newborns discharged in less than 48 hours after delivery;
by 1 month;
2 months;
4 months;
6 months;
9 months;
12 months;
15 months;
18 months;
24 months;
30 months;
once every year for ages 3-20.

You may also request a Child Health Check-Up at other times if you think your child needs it.

Florida's Medicaid Services for Children under the age of 21
Available Services:	As long as it is medically necessary, you can expect:
Physician Services Vision care, including eye exams and glasses Lab tests and X-rays Medicines Medical equipment, including wheelchairs and medical supplies Hearing services, including hearing aids Dental care includes check-ups, cleanings, fillings and more Speech services Mental health services Hospital services, including psychiatric hospitals Help with drug, tobacco and alcohol abuse Physical, respiratory and occupational therapy Home health services and private duty nursing *****UPDATE***** Coverage of Applied Behavior Analysis (ABA) services as described through the provider alerts bolded and italicized below will be replaced by Behavior Analysis (BA) services for Medicaid recipients under the age of 21 years of age (herein referred to as “children”), after Tuesday, February 28, 2017. In addition, BA services will require prior authorization through a vendor contracted with the Agency, Beacon Health Options. The Agency will activate the prior authorization requirement for Behavior Analysis assessments and services on May 15, 2017. All BA assessments and services provided on or after May 15 will require prior authorization in order to be reimbursed. The new service will be delivered by a specific provider type created for BA services (Provider Type 39). Information on Behavior Analysis services can be found at: Behavior Analysis Services Information. The new service will replace coverage of ABA services that is currently reimbursed under the following policies: Community Behavioral Health, Early Intervention Services, and the Individual Budgeting Home and Community-Based Services Waiver. To review a copy of the Behavior Analysis coverage policy, please visit the Rules Page. Applied Behavior Analysis services for children under 21 with autism spectrum disorders Medicaid Applied Behavior Analysis (ABA) Review Form [296KB PDF] Billing Instructions for Developmental Disability waiver providers [45KB PDF] Billing Instructions for Community and Behavioral Health providers [54KB PDF] Billing Instructions for Early Intervention Services providers [48KB PDF] Frequently Asked Questions [242KB PDF] ABA Authorization Requests [64KB PDF] Any other medically necessary service not listed may be requested through Florida Medicaid Special Services process Multi-Specialty Services Prior Authorization Request [39KB PDF] Instructions [464KB PDF]	Services to be free. No co-payment. No limit on approved services. No wait list for services. No total coverage limit on approved services. No limit on the number of visits to the Doctor, Therapist, Dentist, or any other Medicaid Provider. Services covered now that may not be after your child reaches the age of 21.

Florida's Medicaid Services for Children under the age of 21

Available Services:

As long as it is medically necessary, you can expect:

Physician Services
Vision care, including eye exams and glasses
Lab tests and X-rays
Medicines
Medical equipment, including wheelchairs and medical supplies
Hearing services, including hearing aids
Dental care includes check-ups, cleanings, fillings and more
Speech services
Mental health services
Hospital services, including psychiatric hospitals
Help with drug, tobacco and alcohol abuse
Physical, respiratory and occupational therapy
Home health services and private duty nursing

*******UPDATE*******

Coverage of Applied Behavior Analysis (ABA) services as described through the provider alerts bolded and italicized below will be replaced by Behavior Analysis (BA) services for Medicaid recipients under the age of 21 years of age (herein referred to as “children”), after Tuesday, February 28, 2017. In addition, BA services will require prior authorization through a vendor contracted with the Agency, Beacon Health Options. The Agency will activate the prior authorization requirement for Behavior Analysis assessments and services on May 15, 2017. All BA assessments and services provided on or after May 15 will require prior authorization in order to be reimbursed. The new service will be delivered by a specific provider type created for BA services (Provider Type 39). Information on Behavior Analysis services can be found at: Behavior Analysis Services Information.

The new service will replace coverage of ABA services that is currently reimbursed under the following policies: Community Behavioral Health, Early Intervention Services, and the Individual Budgeting Home and Community-Based Services Waiver. To review a copy of the Behavior Analysis coverage policy, please visit the Rules Page.

Applied Behavior Analysis services for children under 21 with autism spectrum disorders
Medicaid Applied Behavior Analysis (ABA) Review Form [296KB PDF]
Billing Instructions for Developmental Disability waiver providers [45KB PDF]
Billing Instructions for Community and Behavioral Health providers [54KB PDF]
Billing Instructions for Early Intervention Services providers [48KB PDF]
Frequently Asked Questions [242KB PDF]
ABA Authorization Requests [64KB PDF]

Any other medically necessary service not listed may be requested through Florida Medicaid Special Services process

Multi-Specialty Services Prior Authorization Request [39KB PDF]

Instructions [464KB PDF]

Services to be free.

No co-payment.

No limit on approved services.

No wait list for services.

No total coverage limit on approved services.

No limit on the number of visits to the Doctor, Therapist, Dentist, or any other Medicaid Provider.

Services covered now that may not be after your child reaches the age of 21.

Services may need a referral or prior approval.

For more information on Child Health Check-Ups, call your health plan, County Health Department, Community Health Center or local Medicaid field office.