as Bright Futures . A separate children’s dental periodicity schedule is also required. One has been developed by the American Academy of Pediatric Dentistry. Improving periodicity schedules can improve access to and utilization of child health services. Treatment and Medical Necessity EPSDT also provides coverage for treatment. All types of child health conditions — medical, dental, mental, developmental, acute, and chronic — must be treated, including pre-existing conditions or those detected outside of an EPSDT comprehensive well-child “screening” visit. EPSDT coverage is set by a federal standard and goes beyond what states may cover for adults in Medicaid. Specifically, states are required by federal law to provide any additional health care services that are covered under the federal Medicaid program and found to be medically necessary regardless of whether the service is covered in a state’s Medicaid plan. Some common EPSDT treatment and intervention services beyond what is typically covered for adults include: eyeglasses, hearing aids, orthodontia, wheelchairs and prosthetic devices, occupational and physical therapy, prescribed medical formula foods, assistive communication devices, personal care, therapeutic behavioral services, and substance abuse treatment Medicaid, as well as private insurers, will not pay for treatment for a covered individual unless they consider it to be medically necessary. In most private health plans, this means the service must be justified as reasonable, necessary, and/or appropriate, using evidence-based clinical standards of care. For children, federal Medicaid law requires coverage of “necessary health care, diagnostic services, treatment, and other measures . . . to correct or ameliorate defects and physical and mental illnesses and conditions.” Thus, the EPSDT medical necessity standard assures a level of coverage sufficient not only to treat an already-existing illness or injury but also to prevent the development or worsening of conditions, illnesses, and disabilities. Dental Dental services must meet standards of dental practice. These standards should be determined by the state following discussion regarding the health of the child. Minimum services should include pain relief, restoration of teeth and maintenance for dental health. EPSDT individuals below the age of 21 are not to be limited emergency services. Medical care providers should provide direct referral to a dentist as part of a comprehensive EPSDT screening visit. If a condition requiring treatment is discovered for a child, EPSDT provides financing for nearly all medically necessary dental services. Vision Vision services, at a minimum, include diagnosis and treatment for defects in vision and eyeglasses