Bright Futures

The Bright Futures program creates and shares clinical national guidelines for pediatric well-child visits. The guidelines help pediatric providers deliver preventive services to children and youths from birth to age 21.

We currently fund the guidelines through a five-year cooperative agreement with the American Academy of Pediatrics (AAP). The cooperative agreement began on May 1, 2023, and ends April 30, 2028.

What should I know about the Bright Futures guidelines?

The guidelines are:

• Age-specific
• Based on the best available scientific evidence
• Intended to increase the quality of primary and preventive care

Why create national guidelines?

Having national guidelines helps all children and youth get the same care at their preventive visits. This helps to support their well-being and prevent illness.

What guidelines resources does the AAP provide?

The AAP Bright Futures Materials and Tools website includes:

• Guidelines and pocket guide
• Nutrition and pocket guide
• Periodicity Schedule
• Tool and resource kit
• Webinars
• Presentations and handouts

The guidelines and pocket guide, nutrition manual and pocket guide, and tool and resource kit are available for purchase. All other materials are free.

Who develops and updates the Periodicity Schedule?

The AAP, a panel of experts, and our administrator all play a part in reviewing and updating the schedule.

What’s the process for updating the Bright Futures Periodicity Schedule?

The Periodicity Schedule can be updated every year. Many steps are involved:

1. Assemble an expert panel: The AAP brings together a panel of experts. They include pediatricians, nurses, and other specialists. These are independent (non-governmental) clinical experts.
2. Review the latest science: The panel reviews medical studies and proven practices related to child health.
3. Build consensus: The panel works together to reach an agreement on best practices.
4. Make recommendations: The panel sends the proposed updates to the HRSA Administrator.
5. Collect public input: HRSA shares the proposed updates with the public through the Federal Register and asks for their feedback. Getting input from parents, caregivers, and others ensures that we consider diverse viewpoints and experiences.
6. Make final recommendations: After the panel considers all the public feedback, it sends its final recommendations to the HRSA Administrator.
7. Sign the guidelines: After review, if they’re approved, the HRSA Administrator accepts the proposed guidelines.
8. Share them: The AAP publishes the guidelines and shares them widely.

What are the latest updates to the Periodicity Schedule?

On December 29, 2023, we accepted an update to the current version of the Bright Futures Periodicity Schedule under Section 2713 of the Public Health Service Act (42 U.S.C. § 300gg-13) and 45 CFR Part 147. For more details, please see the Federal Register Notice from January 1, 2024 (as well as minor corrections in the Federal Register Notice from February 2024).

The updates to the Periodicity Schedule footnotes do not change the clinical recommendations or the requirements for coverage without cost-sharing under section 2713 of the Public Health Service Act.

You can access the current Bright Futures Periodicity Schedule (PDF - 265 KB) through the AAP. To receive updates on Bright Futures along with information on promoting children’s health and preventing illness, subscribe to Bright Futures eNews.

What screenings and assessments does Bright Futures recommend by age?

Review the Recommendations for Preventive Pediatric Health Care (PDF - 265 KB) schedule. This is also called the Periodicity Schedule.

What do pediatric providers do at a well-child visit?

They screen, assess, and follow standard procedures. For example, they:

• Ask about the child’s emotional and physical health
• Examine the child and track their growth
• Vaccinate, as recommended
• Share information to help children and youths stay healthy

At some visits, providers will also screen or assess based on the typical needs of children or youths, or for specific risks at certain ages. 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

Does insurance cover the services Bright Futures recommends?

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

Who else uses the Bright Futures guidelines?

• School-Based Health Alliance
  In special clinics that offer primary care in schools
• Healthy Tomorrows Partnership for Children Program
  In rural or underserved areas
• Centers for Disease Control and Prevention's Child and Adolescent Immunization Schedule
  For ages 18 and younger

How can I get the latest updates?

Read AAP’s Bright Futures eNews. To subscribe, use the contact form.