How often does a child need a well-child visit?
Checkups come close together in the baby years and then settle into one a year. With more than one child, each one sits at a different point on the same schedule.
Arun Verma, co-founder of Triangle · 2026-10-19
This is not clinical evidence and not medical advice. It does not replace your care team. Discuss anything here with your clinician before you act on it.
How often does a child need a well-child visit?
Often in the first few years, then once a year. The Bright Futures/AAP schedule lists visits as a newborn, at 3 to 5 days, by 1 month, and at 2, 4, 6, 9, 12, 15, 18, 24 and 30 months. From age 3 it lists one visit a year, through age 21. That is 12 visits before a child turns 3. The schedule has a stated scope. The AAP says it is designed for children who are receiving nurturing parenting, have no manifestations of any important health problems, and are growing and developing in a satisfactory fashion. It adds that additional visits also may become necessary if circumstances suggest concerns.
Which version of the schedule is current?
The one dated February 2025. The AAP's schedule says it reflects recommendations approved in December 2024 and published in February 2025, and that no changes were made to clinical guidance or footnotes in that version. The schedule says it is updated annually, so a fair question for the office is which version it follows.
What happens at a well-child visit?
A history, measurements, an exam and time to talk. On the AAP schedule, every visit from newborn through 21 includes a history, length or height and weight, a physical examination and anticipatory guidance, which is the talk about what comes next. A footnote calls an age-appropriate physical examination essential at each visit. Some measurements belong to certain ages. Head circumference is on the chart through 24 months, and body mass index starts at 24 months. For Medicaid visits, CMS describes the health education part as anticipatory guidance including child development, healthy lifestyles, and accident and disease prevention.
When are hearing and vision checked?
At set ages, with a quicker risk check at the visits in between. The chart uses a dot for a check that is done and a star for a risk assessment, with appropriate action to follow if positive. It marks vision screening at ages 3, 4, 5, 6, 8, 10, 12 and 15. Its footnote says a visual acuity screen is recommended at ages 4 and 5, as well as in cooperative 3-year-olds, and that instrument-based screening may be used to assess risk at 12 and 24 months. Hearing starts with the newborn screen, and the schedule says to confirm it was completed and verify results. After that it marks hearing screening at 4, 5, 6, 8 and 10. In the teen years the footnote calls for audiometry that includes high frequencies once between 11 and 14, once between 15 and 17, and once between 18 and 21.
How is development checked?
By watching at most visits and with a formal screen at three of them. The AAP chart lists developmental screening at 9, 18 and 30 months and developmental surveillance at the other early visits. HealthCare.gov lists developmental screening for children under age 3 among the preventive services plans cover. If a screen is on the calendar, you could ask what it looked at and when the next check is due.
What if a visit was missed, or a child is new to the practice?
The schedule is built to catch up. Its first footnote says that if a child comes under care for the first time at any point on the schedule, or if any items are not accomplished at the suggested age, the schedule should be brought up to date at the earliest possible time. It is also not a rigid rule. The AAP says the recommendations do not indicate an exclusive course of treatment or serve as a standard of medical care, and that variations, taking into account individual circumstances, may be appropriate. A fair question for the office is which items are still open for each child, and whether they can happen at the next visit.
Does insurance cover well-child visits?
Most plans must. HealthCare.gov says most health plans must cover a set of preventive services for children at no cost, including Marketplace and Medicaid coverage. Its list includes well-baby and well-child visits, vision screening for all children, and height, weight and body mass index measurements. There are limits. HealthCare.gov says these services are generally covered at no cost from an in-network provider, that coverage may vary, and that no-cost coverage isn't guaranteed in all cases. A fair question for your plan is whether your child's doctor is in network.
What does Medicaid's EPSDT benefit cover?
Checkups and follow-up care for children under 21 who are enrolled in Medicaid. CMS says EPSDT provides comprehensive and preventive health care services for them, including checking children's health at periodic, age-appropriate intervals. States set the schedule and may use a nationally recognized one such as Bright Futures; the May 2026 CMS guide for states says most states use Bright Futures. That guide lists five parts of an EPSDT well-child visit, among them a health and developmental history, an unclothed physical exam, lab tests, and health education for the child and family. It also says states must cover medically necessary visits between scheduled checkups, may not limit the number of medically necessary visits a child receives, and that the family does not need to formally request an EPSDT screen.
How do I keep each child's visit records straight?
Against the same schedule, one child at a time. Each child is at a different point on the AAP chart, and its first footnote says that if any items are not accomplished at the suggested age, the schedule should be brought up to date at the earliest possible time. The AAP also says it continues to emphasize the great importance of continuity of care and the need to avoid fragmentation of care. At each checkup, you could ask what the visit covered for that child and when the next hearing and vision checks are due.
Sources
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, chart age row): The Bright Futures/AAP periodicity schedule lists visits at newborn, 3-5 days, by 1 month, 2, 4, 6, 9, 12, 15, 18, 24 and 30 months, then once a year at every age from 3 through 21 years (age row of the chart).
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, chart age row): Counting the chart's age columns from newborn through 30 months gives 12 visits before age 3.
- American Academy of Pediatrics: Preventive Care/Periodicity Schedule (page dated 02/06/2025): AAP says the recommendations are designed for the care of children who are receiving nurturing parenting, have no manifestations of any important health problems, and are growing and developing in a satisfactory fashion.
- American Academy of Pediatrics: Preventive Care/Periodicity Schedule (page dated 02/06/2025): AAP says additional visits also may become necessary if circumstances suggest concerns.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1 header; p. 2, Summary of Changes): The schedule PDF says it is copyright 2025 by the American Academy of Pediatrics, updated February 2025, and reflects recommendations approved in December 2024 and published in February 2025.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 2, Recommendations approved in December 2024): The schedule PDF says no changes have been made to clinical guidance or footnotes in the recommendations published in 2025.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1 header): The schedule PDF says the Bright Futures/AAP Recommendations for Preventive Pediatric Health Care are updated annually.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, chart rows History, Measurements, Physical Examination, Anticipatory Guidance): The chart marks an initial/interval history, length/height and weight, physical examination and anticipatory guidance at every visit from newborn through 21 years.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 2, footnote 17): Footnote 17 says at each visit, age-appropriate physical examination is essential.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, chart rows Head Circumference, Body Mass Index): The chart marks head circumference from newborn through 24 months, and body mass index from 24 months on.
- Medicaid.gov (CMS): Early and Periodic Screening, Diagnostic, and Treatment (Screening Services): CMS lists health education (anticipatory guidance including child development, healthy lifestyles, and accident and disease prevention) among EPSDT screening services.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, key): The chart's key marks a filled dot as to be performed and a star as a risk assessment to be performed with appropriate action to follow, if positive.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, chart row Vision): The chart marks vision screening (to be performed) at 3, 4, 5, 6, 8, 10, 12 and 15 years, and a risk assessment at the other visits.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, footnote 7): Footnote 7 says a visual acuity screen is recommended at ages 4 and 5 years, as well as in cooperative 3-year-olds, and instrument-based screening may be used to assess risk at ages 12 and 24 months.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, footnote 8): Footnote 8 says to confirm the initial (newborn hearing) screen was completed, verify results, and follow up, as appropriate.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, chart row Hearing): The chart marks hearing screening (to be performed) at 4, 5, 6, 8 and 10 years.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, footnote 10): Footnote 10 says to screen with audiometry including 6,000 and 8,000 Hz high frequencies once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, chart rows Developmental Screening, Developmental Surveillance): The chart marks developmental screening at 9, 18 and 30 months, and developmental surveillance at the other visits.
- HealthCare.gov: Preventive care benefits for children: HealthCare.gov's list of covered preventive services for children includes developmental screening for children under age 3.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1, footnote 1): Footnote 1 says if a child comes under care for the first time at any point on the schedule, or if any items are not accomplished at the suggested age, the schedule should be brought up to date at the earliest possible time.
- Bright Futures/American Academy of Pediatrics: Recommendations for Preventive Pediatric Health Care (Periodicity Schedule), updated February 2025 (p. 1 header): The schedule PDF says the recommendations do not indicate an exclusive course of treatment or serve as a standard of medical care, and variations, taking into account individual circumstances, may be appropriate.
- HealthCare.gov: Preventive care benefits for children: HealthCare.gov says most health plans must cover a set of preventive health services for children at no cost, including Marketplace and Medicaid coverage, and that all Marketplace health plans and many other plans must cover the listed services.
- HealthCare.gov: Preventive care benefits for children: HealthCare.gov's list includes well-baby and well-child visits, vision screening for all children, and height, weight and body mass index measurements taken regularly for all children.
- HealthCare.gov: Preventive care benefits for children: HealthCare.gov says these services are generally covered at no cost when provided by an in-network provider, that coverage may vary, and that no-cost coverage isn't guaranteed in all cases.
- Medicaid.gov (CMS): Early and Periodic Screening, Diagnostic, and Treatment: CMS says the EPSDT benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid, and that Periodic means checking children's health at periodic, age-appropriate intervals.
- Medicaid.gov (CMS): Early and Periodic Screening, Diagnostic, and Treatment (Screening Services): CMS says states must consult with recognized medical organizations in developing their screening schedules, or may elect to use a nationally recognized pediatric periodicity schedule (i.e., Bright Futures).
- CMS: EPSDT Guide for States: Coverage in the Medicaid Benefit for Children (May 2026) (p. 6): The CMS guide says most states use Bright Futures, developed by the American Academy of Pediatrics.
- CMS: EPSDT Guide for States: Coverage in the Medicaid Benefit for Children (May 2026) (pp. 5-6): The CMS guide says an EPSDT well-child visit has five components, among them a comprehensive health and developmental history, a comprehensive unclothed physical examination, laboratory testing, and health education and anticipatory guidance for both the child and the family.
- CMS: EPSDT Guide for States: Coverage in the Medicaid Benefit for Children (May 2026) (pp. 6-7): The CMS guide says states are required to cover medically necessary interperiodic screening visits, and that a state may not limit the number of medically necessary health care visits a child receives.
- CMS: EPSDT Guide for States: Coverage in the Medicaid Benefit for Children (May 2026) (p. 7): The CMS guide says that to receive the benefits of EPSDT, the family or child does not need to formally request an EPSDT screen.
- American Academy of Pediatrics: Preventive Care/Periodicity Schedule (page dated 02/06/2025): AAP says it continues to emphasize the great importance of continuity of care in comprehensive health supervision and the need to avoid fragmentation of care.
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