Child Health Check-Up Program Services and Standards

A Child Health Check-up (CHCUP) should be performed by a physician to assess the health status of a Medicaid recipient under the age of 21 in order to identify any existing medical conditions and to coordinate indicated treatment or therapeutic services.

The CHCUP should include a comprehensive health and developmental history, comprehensive unclothed physical examination, developmental assessment; laboratory testing (including blood lead testing), nutritional assessment, health education, (including anticipatory guidance), dental screening, (including
a direct referral to a dentist for Enrollees beginning at three (3) years of age or earlier), vision screening, including objective testing as required, hearing screening, diagnosis and treatment, and referral and follow-up as appropriate. Lead screenings for all members must be done at twelve (12) and twenty-four (24) months of age. In addition, if there is no record of lead screening, members between the ages of 24 months and 72 months of age should also be screened.

Members who’ve been identified with abnormal levels of lead must be provided case management follow-up services. The CHCUP Program also includes immunizations, depending on the age and history of the child. Prestige Health Choice suggests the appropriate immunizations according to the Recommended Childhood Immunization Schedule for the United States.

In addition to the check-up, PCPs should:
• Inform the member when the check-up is due in accordance with the periodicity schedule specified in the
Medicaid CHCUP Handbook.
• Refer the member as indicated by the result of the check-up to the appropriate provider for further assessment and/or treatment within four (4) weeks of these examinations.
• Offer assistance in the appointment schedule, e.g., obtaining state-provided transportation or interpretation services

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