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CHDP Child Health and Disability Prevention Program Medi-Cal Eligible Children and YouthCHDP provides periodic preventive health services to Medi-Cal recipients based on the federally-mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program. All California Medi-Cal recipients from birth to age 21 are eligible for health assessments

Sample CHDP Forms

When Phase 2 of the CHDP Transition to National Standards is effective for dates of service ON or AFTER July 1, 2017, the PM 160 will no longer be used for submitting CHDP claims. This documentation is only applicable for CHDP set up and charge posting for dates of service PRIOR to July 1, 2017. Please refer to Charges --►CHDP--►Transition to National Standards documentation for posting dates of service on or after July 1, 2017.

See also additional information from Medi-Cal website: CHDP Frequently Asked Questions

Child Health and Disability Prevention Program Forms

http://www.dhcs.ca.gov/formsandpubs/forms/Pages/CHDPForms.aspx

Forms pertinent to Los Angeles County, CA:

http://publichealth.lacounty.gov/cms/CHDPForms.htm

See also CHDP Claim Form PM 160 in this documentation.

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