Understanding Child Health Check-Ups Program (CHCUP)

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

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