Definitions

Definitions The Division of Medicaid defines: A. A medically necessary early and periodic screening, diagnosis and treatment (EPSDT) service as a service necessary to correct or ameliorate the individual child’s physical or mental condition with the determination made on a case-by-case basis taking into account the particular needs of the child. B. EPSDT-eligible beneficiary as a beneficiary who meets the requirements of the federally mandated EPSDT program. C. Private duty nursing (PDN) as skilled nursing care services for EPSDT-eligible beneficiaries who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing staff of a hospital or skilled nursing facility. D. Skilled nursing care as a service requiring high-level skills of a registered nurse (RN) or licensed practical nurse (LPN) to provide curative, restorative, and preventative care. These services are rendered under the supervision of an RN and according to a plan of care and treatment created in consultation with the beneficiary’s care team and approved by the beneficiary’s physician.