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Bright Futures

Our Bright Futures Program aims to improve the health of our nation’s infants, children, and adolescents. It does this by maintaining and sharing clinical guidelines that:

  • Are age-specific
  • Are based on the best available scientific evidence
  • Help increase the quality of primary and preventive care

We launched the Bright Futures program in 1990 to address a need for unified guidance on how to design the most modern, efficient, and comprehensive pediatric checkup.

Additional program objectives include:

  • Reviewing new scientific evidence on an ongoing basis and annually publishing relevant updates to Bright Futures periodicity schedule and related resources.
  • Ensuring that accredited pediatric residency programs integrate Bright Futures Guidelines within training.
  • Training practicing primary care clinicians on the use of Bright Futures Guidelines and resources within clinical preventive services.
  • Providing annual training to each of the 59 state maternal and child health (MCH) programs on the use of Bright Futures resources.
  • Providing families with Bright Futures resources to help them prepare for preventive checkup visits with their primary care clinician.

What is the Bright Futures Periodicity Schedule?

One part of the Bright Futures Guidelines is the Periodicity Schedule. The Bright Futures Periodicity Schedule recommends services that pediatric providers should offer at every well-child visit from before birth to age 21. 

All children receive certain assessments, screenings, and procedures at each visit. For example, at each visit the pediatric provider will: 

  • Ask about emotional and physical development
  • Perform a physical examination and track physical growth and development 
  • Provide recommended immunizations
  • Share guidance to help children and adolescents stay healthy

Providers will conduct other assessments, screenings and procedures based on age or specific risks. For example, providers may:

  • Verify the results of newborn screenings
  • Check blood lead levels in early childhood
  • Screen for elevated lipid levels in middle childhood 
  • Assess an adolescent's risk for a sexually transmitted disease or HIV

All non-grandfathered group health plans and health insurance issuers offering group or individual health insurance coverage must cover the services and screenings listed on the current Bright Futures Periodicity Schedule.  

Does insurance cover the services Bright Futures recommends?

Under the Affordable Care Act (ACA), certain group health plans and insurance issuers must provide coverage with no out-of-pocket cost for the comprehensive preventive care and screening services provided for in HRSA-supported guidelines. This includes Bright Futures recommendations. 

What are the latest updates to the Periodicity Schedule?

On December 30, 2022, HRSA accepted an update to the current version of the Bright Futures Periodicity Schedule for purposes of Section 2713 of the Public Health Service Act (42 U.S.C. § 300gg-13) and 45 CFR Part 147). For more details, please refer to the Federal Register Notice

The current Bright Futures Periodicity Schedule (PDF - 344 KB) is available through the American Academy of Pediatrics. Updates will be incorporated into the Periodicity Schedule in spring 2023. To receive updates on Bright Futures along with health promotion and prevention content, subscribe to Bright Futures eNews.

The updates to the Periodicity Schedule are:

  • HIV screening update:

    • Recommended range for universal HIV screening is between the 15-year visit and 21-year visit.

Bright Futures in the broader context

The American Academy of Pediatrics (AAP) is HRSA’s current Bright Futures awardee. AAP’s website offers resources for state-level public health agencies, clinicians, and families, including:

The Centers for Disease Control and Prevention provides the Recommended Child and Adolescent Immunization Schedule for ages 18 or younger (2021).

The National Adolescent and Young Adult Health Information Center at the University of California San Francisco offers Improving Young Adult Health: State & Local Strategies for Success (PDF - 7 MB).

The latest Federal Register Action Notice posted January 5, 2022: Updates to the Bright Futures Periodicity Schedule.

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