Index
A -
B -
C -
D -
E -
F -
G -
H -
I -
L -
M -
N -
O -
P -
Q -
R -
S -
T -
U -
V -
W -
X -
Z
A
Abortion 1 2
Abortion services, family planning funding not used for
Abuse
alcohol and drug use
and neglect
child abuse
compliance with Rider 19
confidentiality
DFPS Abuse Hotline
emotional
learning problems
physical
reporting 1 2 3
procedures for
requirements for
staff training on
screening
sexual
substance abuse 1 2
Abuse and fraud policy
Accessories
durable medical equipment (DME) (home health)
Accident
related claims
resources and refunds
Acronym dictionary
ADA Dental Claim Form Instruction table
Add date for client eligibility
Addendum to Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form
Addiction
see Chemical dependency
Addresses
Appeals, TMHP
Appeals/Adjustments
CPT coding manual
Department of Assistive and Rehabilitative Services (DARS), Blind Services
HHSC
Central offices
Claims Administrator Contract Management
Commissioner
Limited Program
Medical & UR Appeals
Office of Inspector General (OIG) 1 2
Third Party Resources Unit
Presumptive Eligibility Program
Provider Enrollment
Texas Medical Board registration department 1 2
THSteps-CCP
appeals of incomplete claims
first time claims
HHSC written communication
TMHP
Inquiry Control Unit
Medicaid Audit
Special Medical Prior Authorization
Third Party Resources Unit
Adjustments
Adolescent
abuse
alcohol use
cervical cancer
chlamydia testing
communicable disease reporting
depression
drug abuse, screening for
eating disorders
gonorrhea testing
hematocrit
hemoglobin
hyperlipidemia, screening for
learning problems
mental health assessment
pap smear
physical examination
screen, THSteps
sexual behavior
screening procedures
sexually transmitted diseases (STDs)
suicide, screening for
syphilis
tobacco use
tuberculosis testing
Adoption agencies
Advance directives
Advanced practice nurse (APN)
benefits and limitations
claims filing
resources
enrollment
After-hours charges
ambulance night calls
AIS
Alatrofloxacin mesylate
Alcohol
chemical dependency 1 2 3 4 5
safety practices
Aliens, undocumented, legalized, family planning services for
Allergy services 1 2
allergy injections
Alveoloplasty
Ambulance
benefits and limitations
claims filing
claim form example 1 2
denials and appeals
resources
emergency services
enrollment
hospital-based
Medicare disposition
membership fees
nonemergency
transport
prior authorization
nonemergency prior authorization
process
nonemergency services
prior authorization
emergency out-of-state transport
retroactive eligibility
types, definitions
procedure codes
reimbursement
night call
relation to time of death
transports
air or boat
multiple client
nursing facility
out-of-locality
state institutions
to or from state institutions
wait time billing
Ambulatory surgical center (ASC)
benefits and limitations
claims filing
claim form example
claim form example (hospital-based)
resources
dental services
enrollment
hospital-based
reimbursement 1 2
STAR and STAR+PLUS Program enrollment
Amifostine 1 2
Anesthesia
administered by surgeon
base units
claims filing
claim form example
CRNA
dental 1 2
physician 1 2
THSteps dental
time units
Annual exams, family planning
Anti-Spasmodic drugs
Antihemophilic factor
Anzemet
Apnea monitor 1 2
Appeals
administrative claim appeals
AIS appeals
AIS appeals guide
allowed AIS appeals
deadlines
electronic
advantages of electronic appeal submission
allowed electronic appeals
disallowed electronic appeals
electronic submission
family planning
HHSC
complaints to HHSC fee-for-service
exception to the 120-day appeal deadline
exception to the 95-day filing deadline
fee-for-service
managed care
PCCM
paper
submitted incorrectly
telephone appeals
TMHP
administrative claim
cost report settlement
Fee-for-service DRG adjustments appeal
Medicaid Audit
utilization review (UR)
admissions
continued stay denials
DRG changes
medical necessity 1 2
technical denials
Automated Inquiry System
B
Bacillus Calmette-Guérin (BCG) vaccine
Banner pages
Batteries
battery charger
wheelchair
behavioral health services
outpatient, prior authorization for
Behavioral health services
outpatient, prior authorization for
Benefits and limitations
clinician-directed care coordination services (THSteps-CCP only)
occupational therapy
personal care services
private duty nursing
Bilevel positive airway pressure system
with backup (such as BiPAP ST)
without backup (such as BiPAP S)
Billing clients
Biologicals
reimbursement
Birthing center
benefits and limitations
claims filing
claim form example
enrollment 1 2
laboratory services
reimbursement 1 2
STAR and STAR+PLUS Program enrollment
Bladder cancer
Blepharoplasty procedures
Blind Children's Vocational Discovery and Development Program
benefits and limitations
claim form example
claims filing
resources
claims information
enrollment
reimbursement 1 2
STAR and STAR+PLUS Program enrollment
Blood counts 1 2
Blood pressure
devices 1 2
Blood tests
cholesterol 1 2 3
hemoglobin type
lead screening
Blood transfusions
Body mass index (BMI) 1 2
Bone marrow aspiration
Botulinum toxin type A
Breast and Cervical Cancer Program
client eligibility
Breast imaging studies
Breast pumps
Breast reconstruction
C
Cancer screening
Canes, crutches, walkers
Cardiac blood pool imaging 1 2
Case Management for Children and Pregnant Women (CPW) 1 2
assistance with claims concerns
assistance with program concerns
benefits and limitations
child abuse reporting
claims filing
claim form example
eligibility
enrollment
overview
referral process
reimbursement 1 2 3
STAR and STAR+PLUS Program enrollment
Case Management for Early Childhood Intervention
See Early Childhood Intervention (ECI)
Catheters
impantation
Centers for Medicare & Medicaid Services (CMS)
codes
Certified nurse-midwife (CNM)
benefits and limitations
claims filing 1 2
claim form example
deliveries
enrollment
newborn exams
reimbursement 1 2
Certified registered nurse anesthetist (CRNA)
benefits and limitations
claims filing 1 2
claim form example
claims management modifers
enrollment 1 2
epidurals, blood patch
interpreting the R&S report
reimbursement 1 2
STAR and STAR+PLUS Program enrollment
Certified respiratory care practitioner (CRCP)
benefits and limitations
claims filing
claim form example
enrollment
prior authorization
procedure codes
reimbursement 1 2
STAR and STAR+PLUS Program enrollment
Cervical cancer screening
CHAMPUS
Chemical dependency
behavioral health program
behavioral health services
claim filing
claims filing
enrollment 1 2
exceptions to limited status
psychiatric services
reimbursement 1 2
Chemical dependency treatment facility (CDTF)
benefits and limitations 1 2
claims filing 1 2
claim form example
enrollment
outpatient counseling
reimbursement 1 2
STAR, STAR+PLUS, and NorthSTAR Program enrollment
Chemotherapy
drugs
Chest physiotherapy devices
Chest X-rays
Childhood Lead Poisoning Prevention Program
Children's hospitals
CHIP perinatal program
claims
client eligibility verification
program benefits
Chiropractic services
benefits and limitations
claims filing
claim form example
enrollment
reimbursement 1 2
STAR and STAR+PLUS Program enrollment
Chlamydia
Cholesterol 1 2
Chronic lung disease (CLD)
Cidofovir
Circumcisions 1 2
Cladribine
Claims filing
addresses
ambulance
anesthesia
appeal time limits
assistant surgery
banner message R&S example
birthing center
deadline exceptions 1 2
deadlines
durable medical equipment
electronic billing
electronic submission
setting up access
filing tips for outpatient claims
fiscal agent
genetics
home health services
incomplete information
interpretations
modifiers
processing procedures
quick tips
reminders
resubmission of TMHP EDI rejections
telemedicine
THSteps medical modifiers
tuberculosis
Claims filing instructions
abortion
ADA claim form
ambulance transfers
attachments to claims
birthing center
clients without Medicaid numbers
CMS-1500
family planning
Family Planning 2017 Claim Form
home health services
Hysterectomy Acknowledgment Statement
multipage claim forms
occurrence codes (HCFA-1450)
paper claim
provider signature on claims
requirements
sterilization
THSteps Dental
UB-04 CMS-1450
Claims information
family planning
personal care services
private duty nursing
Client
billing 1 2
Client eligibility
add date
Breast and Cervical Cancer Program
CHIP perinatal program
deceased individuals
limited
duration
emergency
emergency care
exceptions
hospital services
Medicaid identification
referrals
restricted Medicaid coverage
selection of provider/pharmacy
long term care
Medicaid eligibility verification
Medicaid Identification
Form H1027
Form H3087
Medicare/Medicaid
clients without QMB, MQMB status
contract with outside parties
QMB/MQMB
NorthSTAR
personal care services
presumptive
retroactive
telephone appeals
THSteps medical check up
THSteps-CCP
verification
Client lift
Clinical Laboratory Improvement Amendments (CLIA)
comprehensive health center
Clinical nurse specialist
benefits and limitations
claims filing
claim form example
resources
enrollment
Medicaid Managed Care enrollment
reimbursement 1 2
Clinical records
Clinician-directed care coordination services (THSteps-CCP only)
Clofarabine
CMS-1500
electronic billing
instruction table 1 2
see CMS-1500
CNS
see clinical nurse specialist
Coding
ambulance procedure codes
ambulance providers
CDT
CPT
diagnosis coding
HCPCS
independent laboratories, pathologists, radiologists
neonatal intensive care codes
nonspecific
place of service (POS) 1 2 3
precoding paper claims
procedure coding
type of bill (TOB)
type of service (TOS)
Commodity supplemental food program
Communicable disease reporting 1 2
Community health centers (CHC)
Comprehensive Care Program (CCP) 1 2
THSteps
Comprehensive health centers (CHC)
Comprehensive outpatient rehabilitation facility (CORF) 1 2
enrollment
THSteps-CCP claims filing
claim form example
Computed tomography angiography (CTA)
radiological and physiological laboratory and portable X-ray supplier
Computed tomography imaging (CT)
radiological and physiological laboratory and portable X-ray supplier
scans
Confidential information
Contact lenses
nonprosthetic
procedure codes
prosthetic
Continuity of care
Continuous positive airway pressure (CPAP)
Contraceptives
devices, family planning
implantable capsules
Contraction stress test
CORF
see Comprehensive Outpatient Rehabilitation Facility (CORF)
Corneal topography
Corner chairs
Corrective shoes
Cost reporting
FQHC
hospital
CPT
CPW
Cranial molding devices
Craniostenosis helmets
Crime Victims' Compensation Program
Croup tent
CSHCN
Medically Needy Program
TPR
CT scans
radiological and physiological laboratory and portable X-ray suppliers
Cyanocobalamin
Cytogam
Cytogenetics testing for leukemia and lymphoma
D
Darepoetin alfa
Date of service (DOS)
DaunoXome
Denileukin Diftitox
see Ontak
Dental
ADA claim form
adjunctive general services
anesthesia 1 2
criteria 1 2
benefits and limitations
billing
caries
claims and appeals 1 2
claims filing
claim form, paper billing
instructions
client eligibility
client rights
complaints
dental assessment guidelines for THSteps medical providers
dentures
diagnostic services
doctor of dentistry practicing as a limited physician
electronic claim billing
emergency services
clients over 21
long term care
endodontics
fee schedule
general information
handicapping labiolingual deviation (HLD)
HLD score sheet 1 2
hospitalization
implant services
informed consent
mandatory prior authorization
medical necessity
oral soft tissues
oral/maxillofacial surgery
orthodontic procedure codes
orthodontic services
comprehensive treatment
mandatory prior authorization
special orthodontic appliances
transfer of services
treatment plans
patient education
periodicity
periodontal services
permanent teeth
preventive services
primary teeth
prophylaxis
prosthodontics
removable
provider enrollment
radiographs
referrals
reimbursement
reporting child abuse or neglect
restorations
root canal therapy
sealants
services
services (THSteps)
space maintenance (passive appliance)
supernumerary tooth identification
tests and examinations
therapeutic services
third party resources
THSteps
screening 1 2
THSteps dental services
TMHP contact information
tobacco use
tooth identification (TID) and surface identification (SID)
treatment plans
utilization review
Dentist
doctor of dentistry
Dentures
Department of Assistive and Rehabilitative Services (DARS), Blind Services
contact information
Developmental assessment
Diabetic drugs
Diabetic supplies/equipment
Diagnosis coding
Dialysis 1 2
claim form example
Disallowed appeals
family planning
DME
replacement
Docetaxel
Doctor of dentistry
claims filing
claim form example
limited physician
claims information 1 2
diagnosis codes
mandatory prior authorization
Medicaid Managed Care enrollment
Donor human milk
Doppler studies
Drug abuse
and learning problems
psychiatric services
Drugs
anti-spasmodic
chemotherapeutic
diabetic
opioid
reimbursement
DSHS
Women's Health Laboratories, Cytopathology Department
durable medical equipment (DME)
accessories (home health)
modifications (home health)
Durable medical equipment (DME)
accessories (THSteps-CCP)
adjustments (THSteps-CCP)
bathseats
benefits and limitations (THSteps-CCP)
blood pressure devices
claims filing
claim form example (THSteps-CCP)
enrollment
incontinence supplies (THSteps-CCP)
mobility aids coding (THSteps-CCP)
modifications (THSteps-CCP)
physician signature (THSteps-CCP)
prior authorization
reimbursement (THSteps-CCP)
rental (THSteps-CCP)
repairs (THSteps-CCP)
repairs (THSteps)
respiratory care equipment (THSteps-CCP)
supplier (THSteps-CCP)
supplier policies (THSteps-CCP)
THSteps-CCP
Durable medical equipment (DME) Certification and Receipt Form
E
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)
see Texas Health Steps (THSteps)
Early childhood caries
Early Childhood Intervention (ECI) 1 2
benefits and limitations 1 2
case management
CCP services
claims filing 1 2 3
claim form example (THSteps-CCP only)
enrollment 1 2 3
referrals
reimbursement 1 2 3
STAR and STAR+PLUS Program enrollment
Early Chilhood Intervention (ECI)
THSteps
Eating disorders
Echoencephalography
Echography
EDI
electronic billing
forms
requests for electronic transmission reports
setting up access
software
TexMedConnect
TMHP website
training
vendor implementation
supported file types
vendor software
Education
family planning
Electric lift
Electrical percussor
Electrocardiogram (EKG)
Electromyography (EMG)
Electronic appeal submission
family planning
Electronic blood pressure monitoring device
Electronic claims submission
see TMHP EDI
Electronic Data Interchange
see EDI and TMHP EDI
Electronic funds transfer
advantages
enrollment procedures
using
Eligibility
client
refer to type of provider
see also client eligibility
Emergency
ambulance
emergency care restrictions 1 2
restricted coverage
Emotional abuse
Emphasis> (TEFRA)
Enclosed beds
Encounter data, collecting
Endodontics
Endoscopy
bronchoscopy
cystourethroscopy
endoscopic retrograde cholangiopancreatography (ERCP)
lower gastrointestinal endoscopy
sinus endoscopy
upper gastrointestinal endoscopy
Enrollment
advanced practice nurse (APN)
ambulance
ambulatory surgical center (ASC)
birthing center
Blind Children's Vocational Discovery and Development Program
Case Management for Children and Pregnant Women (CPW)
certified nurse-midwife (CNM)
certified registered nurse anesthetist (CRNA)
certified respiratory care practitioner (CRCP)
chiropractic services
clinical nurse specialist (CNS)
Early Childhood Intervention (ECI)
electronic funds transfer
hospital
licensed clinical social worker (LCSW)
nurse practitioner (NP)
outpatient rehabilitation centers
personal care services
physical therapist
physician
physician assistant (PA)
private duty nursing
provider
psychologist 1 2
THSteps-CCP 1 2
vision
Enteral nutritional products
Enzyme immunoassay
Epidural
programmable pumps
EPSDT
see also Texas Health Steps (THSteps)
Erythropoietin alfa (EPO) 1 2 3
Esophageal pH probe monitoring
Exceptions to periodicity
External insulin pumps
Extracorporeal membrane oxygenation (ECMO)
Eye exams
F
Face-to-face services
Family planning
annual exams
appealing claims
billing for non-family planning services
billing HMOs for out-of-network services
claims information
client contraceptive choice
collecting encounter data
contraceptive devices and related procedures
diagnosis codes
disallowed appeals
dispensing medication
drugs and supplies
education
electronic appeal submission
electronic Title X claims
filing deadlines
incomplete sterilization
injection administration
laboratory procedures
limited Medicaid coverage
Medicaid Managed Care claims
medical counseling
natural method
nutritionist
other office visits
outpatient visits
paper appeal submission
parental consent
problem counseling
procedure codes
provider enrollment
provider guidelines
provider requirements
radiology
rural health clinic providers
services
services for undocumented aliens, legalized aliens
sterilization
teen group counseling
third-party insurance
Title X claims
Title X other EDI claims
Title X paper claims
Title X payments
Title XIX enrollment 1 2
tubal ligation
vasectomy
Family Planning Services
claims filing
claim form example
claim form example (APN)
PCCM
reimbursement
Sterilization Consent Form
Family Planning Services for Hospitals, FQHCs
claims filing
claim form example
Federal financial participation (FFP) rate
Federally qualified health center (FQHC)
benefits and limitations
claims filing
claim form example
claim form example (follow-up)
resources
enrollment 1 2
medically necessary services
Medicare-Medicaid crossover claims pricing
newborn eligibility
reimbursement
STAR and STAR+PLUS enrollment
telemedicine
Fee schedules
dental
orthodontic
Feeder seats
Ferritin and iron studies
Fetal fibronectin
Filgrastim
Filing deadlines
110-day rule
95-day 1 2
family planning
Floor sitters
Fluocinolone acetonide
Forms
1120 Medical Bills Transmittal
3652A Client Assessment Review and Evaluation (CARE) Form
Abortion Certification Statements Form
Ambulance Fax Cover Sheet
American Dental Association (ADA) claim form
Authorization to Release Confidential Information
Birthing Center Report (Form 7484)
Child Abuse Reporting
Child Health History
Claim form examples
CMS-1500
Credit Balance Refund Worksheet
DME Certification and Receipt Form
Donor Human Milk Request Form
Electronic Funds Transfer (EFT) Authorization Agreement
Electronic Funds Transfer (EFT) Information
Electronic Remittance and Status (ER&S) Agreement
Electronic Remittance and Status Agreement
Extended Outpatient Psychotherapy/Counseling Request Form
External Insulin Pump
Federally Qualified Health Center Report (Form 7484)
Hearing Evaluation and Fitting and Dispensing Report (Form 3503)
Home Health
Addendum to Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form
Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form
Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form Instructions
Home Health Services Plan of Care (POC)
Plan of Care
Prior Authorization Checklist
Hospital Report (Form 7484)
Hysterectomy Acknowledgment Form
Informational Inquiry Form
Medicaid Certificate of Medical Necessity for Chest Physiotherapy Devices
Extended Request
Initial Request
Medicaid Certificate of Medical Necessity for CPAP/BiPAP or Oxygen Therapy
Medicaid Certificate of Medical Necessity for In-Home Total Parenteral Hyperalimentation
Medicaid Certificate of Medical Necessity for Reduction Mammaplasty
Medicaid Identification
Medicaid Identification (Form H3087) 1 2 3 4 5 6
Medicaid verification letter (Form H1027-A)
Medicaid verification letter (Form H1027-B)
Medicaid verification letter (Form H1027-C)
Nursing Addendum to Plan of Care
Other Insurance Form
PCCM
Behavioral Health Consent Form
Behavioral Health Consent Form (Spanish)
Community Health Services Referral Request Form
Inpatient/Outpatient Authorization Form
Pre-Contractual/Recredentialing Site and Medical Record Evaluation 1 2
Referral Form
Physician's Examination Report
Physician's Medical Necessity Certification for Nonemergency Ambulance Transports
Prior Authorization Request Form
Intrathecal Baclofen or Morphine Pump Section II
Intrathecal Baclofen or Morphine Pump Sections I and II
Private Pay Agreement
Provider Information Change Form
Psychiatric Hospital Inpatient Initial Admission Request Form
Psychiatric Inpatient Extended Stay Request Form
Pulse Oximeter Form
Radiology Prior Authorization Request
Refund Information Form
Request for Electronic Funds Transfer
Request for Extension of Outpatient Therapy (Form TP-2)
Request for Initial Outpatient Therapy (Form TP-1)
Sample letter - signature on file
Specimen Submission Form G-1C, Maternal Serum Prenatal Triple Screen
Specimen Submission Form G-1C, Maternal Serum Prenatal Triple Screen (Spanish)
Specimen Submission Form G-1C, Maternal Serum Prenatal Triple Screen, Instructions
Specimen Submission Form G-1C, Maternal Serum Prenatal Triple Screen, Spanish Instructions
Statement for Initial Wound Therapy System In-Home Use
Sterilization Consent Form
English
Instructions
Spanish
Texas Medicaid Palivizumab (Synagis) Prior Authorization Request Form
Texas Medicaid Vendor Drug Program Palivizumab (Synagis) Prescription Form
THSteps
Cervical Cancer Cytology Laboratory
Child Health Clinical Records
Child Health History
Child Health Record
13 Months-2 Years
2-6 Months
3-5 Years
6-10 Years
7-12 Months
Birth-1 Month
Dental Criteria for Dental Therapy Under General Anesthesia
Dental Mandatory Prior Authorization Request
ECI Request for Outpatient Therapy
Form Pb-110, Risk Assessment for Lead Exposure
Hearing Checklist for Parents 1 2
Mental Health Interview Tool/Referral Form
0-2 Years
0-2 Years (Spanish)
10-12 Years (Spanish)
Ages 10-12 Years
Ages 13-20 Years
Ages 13-20 Years (Spanish)
Ages 3-9 Years
Ages 3-9 Years (Spanish)
Mental Health Parent Questionnaire
Ages 10-12 Years
Ages 10-12 Years (Spanish)
Ages 13-20 Years
Ages 13-20 Years (Spanish)
Ages 3-9 Years
Ages 3-9 Years (Spanish)
Ages Birth-2 Years
Ages Birth-2 Years (Spanish)
PPD Agreement for Texas Health Steps Providers
Prior Authorization Request
Private Duty Nursing 4 or 6 Month Authorization
Referral Form
Referral Form Instructions
Risk Assessment for Lead Exposure
San Antonio State Chest Hospital Cervical Cancer Cytology Laboratory
Specimen Submission Form G-1B
instructions
Specimen Submission Form G-1B, Biochemistry Spanish 1 2
Specimen Submission Form G-1B, Biochemistry, Spanish Instructions
Specimen Submission Form G-2A, Serology and Virology
Specimen Submission Form G-2A, Serology and Virology (Spanish)
Specimen Submission Form G-2A, Serology and Virology, Instructions
Specimen Submission Form G-2A, Serology and Virology, Spanish Instructions
Specimen Submission Form G-2B, Bacteriology and Parasitology
Specimen Submission Form G-2B, Bacteriology and Parasitology (Spanish)
Specimen Submission Form G-2B, Bacteriology and Parasitology, Instructions
Specimen Submission Form G-2B, Bacteriology and Parasitology, Spanish Instructions
Tuberculosis
Guidelines, Skin Testing
Questionnaire
Questionnaire (Spanish)
Screening and Education Tool
TVFC
Patient Eligibility Screening Record
Patient Eligibility Screening Record (Spanish)
Provider Enrollment
Questions and Answers
THSteps Dental Criteria for Dental Therapy Under General Anesthesia 1 2
Tort Response Form
TP-1
TPN
Triplicate prescription form
UB-04 CMS 1450
Ventilator Service Agreement
Vision Care Eyeglass Patient Certification Form
English
Spanish
Wheelchair Seating Evaluation Form
Wound Therapy System In-Home Use
Recertification
Frames
dispensing
eyeglasses
nonprosthetic
prosthetic 1 2
repairs
replacements
Fraud and abuse
fines
suspected cases
Fraud and abuse policy
G
Gait trainers
Galsulfase
Gamma knife radiosurgery
Gemcitabine HCI 1 2
Gene mutation analysis, prior authorization for
Genetics
benefit schedule
claims filing
claim form example
genetic evaluation and counseling
reimbursement 1 2
Gonorrhea
Granisetron hydrochloride
Growth hormone
H
Handicapping labiolingual deviation (HLD)
Health Education/Anticipatory Guidance
adolescent development
dental
safety practices
Health maintenance organization (HMO)
Healthcare Common Procedure Coding System (HCPCS)
Hearing
hearing services
screening 1 2 3
adolescent
children, 11 years of age and older
children, 4 years of age and older
diagnostic testing 1 2
early hearing detection and intervention
impedance testing
infants, birth-3 years of age
initial test at birth
newborn
outpatient screening requirements 1 2
puretone audiometer 1 2
referral
THSteps services
Hearing aid and audiometric evaluations
4 years of age and older
birth thorugh age 3 years of age
claims filing
claim form example
enrollment
hearing referrals
hearing screenings
initial test at birth
newborn hearing screening
prior authorization
reimbursement
Heart transplants 1 2 3
Helicobacter pylori 1 2
Hematopoietic agents
Hemoglobin type
Hepatitis B
immunizations
screening of pregnant women
vaccine
HHSC
appeals to
central office addresses
complaints and fair hearings
complaints to
managed care
PCCM
Public Health Region contacts
Public Health Regions map
regional offices
Medicaid eligibility staff
HIV/AIDS
model workplace guidelines
testing
Home health services
ACD systems
augmentative communication device system
authorization of retroactive eligibility
blood glucose monitors
canceling an authorization
certification
change of address/telephone number
claim form example
DME/medical supplies
skilled nursing visit and physical therapy
skilled nursing visits
claims information
client evaluation
corner chairs
criteria for grouping levels
decubitus care accessories
diabetic supplies/equipment
durable medical equipment (DME)
enrollment 1 2
enteral feeding pumps
exclusions
feeder seats
floor sitters
group 1 support surfaces
group 2 support surfaces
group 3 support surfaces
home health aide services
home health aide visits
hospital beds and equipment procedure code
incontinence supplies and equipment
insulin and insulin syringes
limitations 1 2
medical supplies
Medicare/Medicaid reimbursement
medication administration limitations
mobility aids
procedure codes and limitations
nursing services
nutritional productions and supplies
occupational therapy
prior authorization procedures
physical therapy services 1 2 3
prior authorization
possible Medicare clients
prior authorization 1 2
professional nursing
prohibition of Medicaid payment
pulsatile jet irrigation wound care system
reimbursement
respiratory equipment and supplies
procedure codes and limitations
retroactive eligibility
sealed suction wound care system
skilled nursing and home health aid services provider responsibilities
skilled nursing and home health aide services assessments and reassessments
skilled nursing and home health aide services not prior authorizated
skilled nursing and home health aide services prior authorization requirements
skilled nursing care
skilled nursing visits
supervision of home health aides
supplies submitted with a plan of care
travel chairs
vocational nursing
wound care
supplies
systems
criteria
thermal system
written plan of care
Hormone injections
Hospice Program
Hospital
acknowledgment of penalty notice
beds
cost reporting
diagnosis related group (DRG)
emergency department services
general information
hospital ambulatory surgical center
inpatient
benefits and limitations
change of ownership
claim form example
claims filing
claims information
client transfer
CRNA services
enrollment
hospital ambulance
newborn services
observation status to inpatient admission
outliers
propsective payment methodolgy (DRG)
psychiatric hospital/facility (THSteps-CCP)
reimbursement
STAR and STAR+PLUS Program enrollment
utilization review
Medicaid relationship to Medicare
nursing facility admission
outpatient
benefits and limitations
change of ownership
claim form example
claims filing 1 2
day surgery services
enrollment
hospital ambulance
observation room services
reimbursement
revenue codes
STAR and STAR+PLUS Program
total parenteral hyperalimentation
utilization review
reimbursement
sanctions
services
abortion
aerosol treatment
bacillus calmette-Guzin (BCG) vaccine
chemical dependency
chemotherapy
colorectal cancer screening
computerized tomography (CT)
contraction stress test
deep brain stimulators
gamma knife radiosurgery
Helicobacter pylori
hyperbaric oxygen therapy
hysterectomy services
laboratory services
neuropsychological testing
nonstress testing
osteopathic manipulation treatment (OMT)
pentamidine aerosol
psychiatric services 1 2
psychological testing
pulmonary function studies
radiation therapy
radiology services
rehabilitation services
tetanus injections, acute care
Tax Equity and Fiscal Responsibility Act<
third party liability reporting
transplant center approval
utilization review appeals
Human donor milk
Hydraulic lift
Hyperalimentation
Hyperbaric oxygen therapy
Hyperlipidemia
Hypertension
adolescent
Hysterectomy
Acknowledgment Statement
claims filing instructions
I
Ibutilide Fumarate
ICD-9-CM
Idarubicin/Idamycin PFS injection
Ilizarov device
Imitrex
ImmTrac 1 2
Immune globulin (Cytogam)
Immunizations 1 2
consent forms
free vaccines
general recommendations
hepatitis B
instructions
provider reimbursement fee
Recommended Childhood and Adolescent Immunization Schedule
Recommended Childhood Immunization Schedule
tetanus
Immunosuppressive drugs
In-home total parenteral hyperalimentation
prior authorization
In-home total parenteral hyperalimentation supplier
benefits and limitations
claims filing
claim form example
enrollment
Medicaid Managed Care enrollment
reimbursement 1 2
In-home total parenteral nutrition (TPN)/hyperalimentation
supplier
In-home total parenteral nutrition (TPN)/hyperalimentation supplier
Incomplete sterilization
family planning
Incontinence
equipment
procedure codes with limitations
supplies 1 2
Independent laboratory
basic metabolic panel
benefits and limitations
cancer screening, colorecal
claims filing
claim form example
resources
CLIA regulations
electronic filing for laboratory
enrollment
laboratory services for people on dialysis
limitations
microquantative sweat test
modifier 76
modifier 91
paneling
physician-performed microscopy procedure certificates
reference labs and lab handling
reimbursement 1 2
repeated procedures
STAR and STAR+PLUS enrollment
THSteps outpatient laboratory services
transfusion medicine
waiver certificate
Independent practitioners
reimbursement
Indian Health Services
reimbursement
Indian Self-Determination and Education Assistance Act
Infliximab
Influenza vaccine
Injections
administration of
allergy
cladribine
daunoXome
denileukin diftitox
see Ontak
docetaxel
dolasetron mesylate
see Anzemet
gamma globulin/immune globulin
gemcitabine HCI 1 2
granisetron hydrochloride
growth hormone
hepatitis B vaccine
hormone
idarubicin/idamycin PFS
imitrex
infliximab
influenza vaccine
interferon
intralesional
irinotecan
joint and trigger point
leuprolide acetate
linezolid
maternal serum alpha-fetoprotein
melphalan hydrochloride
modifiers
paclitaxel
pegfilgrastim
pentagastrin
porfimer
sargramostim
tetanus
Insulin pump
Interferon
Internal control number (ICN)
Intestinal transplants
Intraocular lenses
Intrathecal infusion
programmable pumps
intrauterine device (IUD)
Intravitreal drug delivery system
Iridectomy/iridotomy/trabeculectomy
Irinotecan
IUD (intrauterine device)
L
Laboratory
follow-up care guidelines
hyperlipidemia
procedures
required tests for medical check ups
newborn screening
urinalysis
screening procedures 1 2
see also Independent laboratory
services 1 2
specimen submission
supplies 1 2
THSteps services
Laboratory procedures
family planning
LCSW
see Licensed clinical social worker (LCSW)
Lead screening 1 2
lead poisoning prevention
educational materials
Learning
disorder
problems
Legislative requirements
Leuprolide acetate (Lupron Depot)
Leustatin
Levels for custom manual wheelchairs
Licensed clinical social worker (LCSW)
benefits and limitations
claims filing
claim form example
encounter limit
reimbursement 1 2
Licensed dietitian
claims filing
enrollment 1 2
physician signature
reimbursement
THSteps-CCP claim form example
Licensed marriage and family therapist (LMFT)
claims filing
claim form example
documentation requirements
encounter limit
enrollment
reimbursement 1 2
Licensed physician assistant
Licensed professional counselor (LPC)
benefits and limitations
claims filing
claim form example
documentation requirements
encounter limit
enrollment
Medicaid Managed Care Enrollment
reimbursement 1 2
Limitations, Medicaid Program
noncovered procedures
Linezolid
Lioresal
see Baclofen
Liver transplants 1 2
Local health departments contacts
LoneSTAR Select Contracting Program
Managed Care
Lung transplants 1 2
M
Magnetic resonance angiography (MRA)
radiological and physiological laboratory and portable X-ray supplier
Magnetic resonance imaging (MRI)
radiological and physiological laboratory and portable X-ray supplier
Mammography
Managed care
advance directives
after-hours guidelines
client responsibilities
client rights
complaints and fair hearings
continuous coverage
cultural competency
health plan changes
overview
primary care provider
eligible provider types
primary care provider changes
requirements
see also PCCM
STAR Program
third party resources
Manual pricing
Manual wheelchairs
custom
standard
Mastectomy
Maternal and child health
services block grant program
Maternal serum alpha-fetoprotein
Maternity care
Maternity service clinic
assessment
claims filing 1 2
claim form example 1 2
classification of risk
documentation requirements
education/counseling
enrollment
history
interim history
intial antepartum care visit components
laboratory tests 1 2
physical examination 1 2
postpartum care visit
reimbursement
risk assessment
STAR and STAR+PLUS Program enrollment
subsequent antepartum care visits
MAXIMUS
Medicaid Identification
Form H3087
see also Forms
Medicaid Qualified Medicare Beneficiary (MQMB) 1 2
client eligibility
Medicaid relationship to Medicare
Medicaid verification letter
see Forms
Medicaid, Texas Program
client eligibility 1 2
client number
fraud and abuse policy
medical home concept
medical necessity, definition
relationship to Medicare
requirements for participation
restricted coverage
verification documents
Medical check up
birth through 20 years of age
dental guidelines
dental referral
developmental screening
hearing screening 1 2
laboratory
submission of specimens
supplies
nutritional assessment
physical examinations
procedures and tests 1 2 3 4
referrals 1 2 3
verification of
Medical counseling
family planning
Medical history
birth through 20 years of age
Medical home
concept
continuity of care
freedom of choice
mobile units
Medical nutritional products
Medical transportation
contacting MTP
eligibility
program limitations 1 2
requirements
Medically complex
Medically Needy Program (MNP)
claims filing
clearinghouse
closing MNP case
CSHCN clients
spend down processing
Medicare
fraud and abuse policy
Medicare Catastrophic Coverage Act of 1988
Medicare crossover reimbursement
Medicare/Medicaid
relationship between
vision
Melphalan hydrochloride
Mental health
screening (THSteps)
Mental health (MH) mental retardation (MR)
benefits and limitations
billing units
claims filing
enrollment
mental health rehabilitation
rehabilitative services limitations
reimbursement 1 2
service coordination contact codes
STAR Program enrollment
Mental health case management
claim form example
claims filing
claim form example
Mental health services, outpatient, prior authorization for
Migrant health centers
Military hospital
benefits and limitations
claims filing
claim form example (emergency inpatient)
enrollment
inpatient services
reimbursement
STAR Program enrollment
utilization review
Mobile units
enrollment
medical
Mobility aids
THSteps-CCP DME
Modifications to durable medical equipment (DME)
home health
Modifiers 1 2
ambulance claims
MTP
See Medical transportation
Multidisciplinary care
Muscular Dystrophy Association
Myocardial perfusion imaging 1 2
N
Natural family planning method
Nebulizers
Negative pressure ventilators
Nerve conduction studies
Newborn
birthing center
blood screening
claim hints
federally qualified health center
hearing screening
1-3-6 Month Practitioner's Guide
birth screen
instructions
resuscitation 1 2
routine care
services 1 2
apnea monitors
circumcisions
testing
THSteps examination
Non-face-to-face
care clan oversight
clinician supervision of a home health client
clinician supervision of a hospice client
documentation
medical conferences
prolonged services
Noncoronary percutaneous transluminal angioplasty
Nonprosthetic eyewear
Nonstress testing
NorthSTAR Program
claims filing
client eligibility
client enrollment
complaints and appeals
guidelines for working with NorthSTAR clients
hospital billing
overview
provider requirements
quality improvement monitoring
service area
NP
see nurse practitioner
Nuclear medicine
Nurse
see certified nurse midwife, nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist
Nurse practitioner
benefits and limitations
claims filing
claim form example
resources
enrollment
Medicaid Managed Care enrollment
reimbursement 1 2
Nursing services
Nutritional (enteral) products, supplies, and equipment
Nutritional screening
Nutritionist
family planning
O
OB-GYN provider enrollment
Observation 1 2
less than 24 hours
outpatient 1 2 3
billing
Obstetrics/prenatal care
Obtaining palivizumab
Occupational therapists
claims filing
claim form example (THSteps-CCP)
enrollment 1 2
physician signature
prior authorization
reimbursement
Occupational therapy
services 1 2
Occurrence codes
UB-04 CMS-1450
Office visit with lab and radiology
claim form example
Ontak
Ophthalmology 1 2
Opioid drugs
Opticians
reimbursement
Optometrists 1 2
reimbursement
Oral surgery
Organ
procurement
transplant services
Orthodontic services
mandatory prior authorization
procedure codes
special orthodontic appliances
Orthotic and prosthetic suppliers
benefits and limitations
claims filing
claim form example (THSteps-CCP)
enrollment
physician signature
prior authorization
reimbursement
Orthotic and Prosthetic Suppliers (THSteps-CCP Only)
claims filing
claim form example
Osteopathic Manipulation Treatment (OMT)
Outliers
cost outlier
day outlier
Outpatient
military hospital physician services
observation
physician services in an outpatient hospital setting
Outpatient facilities
reimbursement
Oximeter
Oxygen therapy
home delivery system types
initial medical necessity certification
recertification
P
Paclitaxel
PACT
see Program for Amplification for Children of Texas
palivizumab
obtaining
Palivizumab (Synagis)
Paneling
chemistry tests
complete blood counts
laboratory
organ
urinalysis
Pap smear 1 2 3
Paper appeal submission
family planning
Parapodium
Parental accompaniment 1 2
Patient Acknowledgment Statement
PCCM
access and availability standards
authorization
definitions
denials and appeals (inpatient)
facility services
inpatient
professional services (inpatient)
behavioral health services
case management fee
client eligibility
client enrollment
client responsibilities
community health services
complaints and appeals
contact numbers
covered services
behavioral health services
family planning services
OB/GYN services
Texas Health Steps
vision services
credentialing committee
ER services
facility/hospital services
linguistic services
monthly member panel report
notification of admission 1 2
newborns
scheduled admissions
observation services
office and medical record standards
confidentiality of medical records
medical records audit
provider site requirements
panel closings
primary care provider
primary care provider selection
services to be provided
verifying assignment
prior authorization
outpatient
procedures requiring
provider enrollment
provider responsibilities
referrals
client self-referred services
referral form
referral network
specialist-to-specialist
reimbursement
emergency outpatient services
network hospitals
non-emergency outpatient clinic services
out-of-network hospitals
PCCM claims details
specialists responsibilities
support services
transportation services
Pediatric hospital cribs
Pediatric nurse practitioner
see nurse practitioner
Pediatric pneumogram
Pegfilgrastim
Pentamadine, aerosol
Percutaneous transluminal coronary intervention
Percutaneous/transcutaneous nerve stimulators
Periodicity schedule
10 through 20 years of age
birth through 9 years of age
exceptions
THSteps medical check up
personal care services
client eligibility
Personal care services
provided in group settings
provider responsibilities
Personal care services (THSteps-CCP only)
Pharmacists
eligibility (THSteps-CCP)
THSteps-CCP
claims
enrollment 1 2
reimbursement
triplicate prescription form
Pharmacy
claim form example (THSteps-CCP)
client limited
Phlebotomy therapeutic
Phototherapy devices
Physical abuse
Physical examination
10 through 20 years of age
birth through 20 years of age
Physical therapists 1 2 3
claims filing
claim form example
documentation requirements
ECI Program
provisions for therapy services
enrollment
rehabilitation
reimbursement 1 2
services
STAR and STAR+PLUS Program enrollment
THSteps-CCP
claim form example
claims filing
enrollment
physician signature
prior authorization
reimbursement
Physical therapy services
Physician
certified nurse-midwife
claims filing 1 2
comprehensive health centers (CHC)
dentistry, doctor of
enrollment
evaluation and management services
inpatient services
claims filing deadlines
concurrent care
domiciliary, rest home, or custodial care
home services
hospital discharge
nursing facility services
Medicaid Managed Care enrollment
office or other outpatient services
consultation services
emergency department services by physicians
new and established patient services
observation services
preventive care visits
services outside of business hours
outpatient hospital reimbursement
physician assistants (PAs)
prior authorization
procedures and services
referrals
see also PCCM, referrals
reimbursement 1 2
services
aerosol treatment
allergy 1 2
ambulatory electroencephalogram (A/EEG)
amniocentesis
anesthesia
base units
central lines
complicated
for sterilization
for THSteps dental restoration
multiple procedures
reimbursement methodology
time units
anesthesiology
antihemophilic factor
apnea monitors
assessment of higher cerebral function testing
Bacillus Calmette-Guérin (BCG)
bone marrow aspiration
cancer
casting
central nervous system simulators
chemotherapy
chronic spasticity
circumcision
clinical pathology consultations
cochlear implant
contraction stress testing
corneal transplants
CT scan
cytopathology studies
other than gynecological
diagnostic tests
doppler studies
echoencephalography
echography
echography ophthalmic biometry, A-mode
echography scan, opthalmic
elective sterilization services
electrocardiogram (EKG)
electromyography (EMG)
endoscopy
epidural/subarachnoid infusion
external cephalic version
extracorporeal membrane oxygenation
eye surgery
incision
laser
gamma knife radiosurgery
genetic testing
gynecological services
Helicobacter pylori
hyperbaric oxygen therapy
incidental to surgery and/or anesthesia
injections
intraocular lenses
laboratory
clinical lab panel implementation
long term care nursing facility
magnetic resonance angiography (MRA)
magnetic resonance imaging (MRI)
mammograms
mastectomy and breast reconstruction
maternity care
myocardial perfusion imaging
nerve conduction studies
neuropsychological testing
neurostimulators
newborn
hearing screening
resuscitation
newborn examination
noninvasive diagnostic studies
nonstress testing
nuclear medicine
obstetrics/prenatal care
occupational therapy
ophthalmology 1 2
optometrist
orthognathic surgery
pain management
pap smears
pelvic ultrasound
physical therapy 1 2
limitations
polysomnography
psychological testing
radiation therapy
radiology
reduction mammoplasties
renal disease
sleep studies
speech-language therapy
splinting
strapping
surgery
telemedicine
transplant prior authorization
vagal nerve stimulators
ventilation assist and management
substitute physician
supervision
of CRNA
teaching attending physician and resident physician
supplies, trays, and drugs
visits
hospital
Physician assistant
reimbursement 1 2
Physician assistant (PA)
benefits and limitations 1 2
claims filing
resources
enrollment
Medicaid Managed Care enrollment
Physiological laboratory
reimbursement
Place of service (POS)
see also Coding
Pneumococcal 7-valent conjugate vaccine
Pneumococcal polysaccharide vaccine
Pneumogram, pediatric
Podiatrist services
clubfoot casting
echography/ultrasound of extremity
flat foot treatment
in a nursing facility
nerve conduction studies
routine foot care
vascular studies
Polysomnography
Porfimer
Portable X-ray supplier
reimbursement
Power wheelchairs
custom
standard
Preadmission Screening and Annual Resident Review (PASARR)
Premature infants
eligibility
obstetrics/prenatal care
Prenatal care
Prescriptions
delivery
Primary care provider
see Managed care
prior authorization
mobility aids
outpatient behavioral health services
psychological testing
ramps
strollers
THSteps benefits
THSteps-CCP numbers for
Prior authorization
ambulance
nonemergency retroactive eligibility
nonemergency services
process
Certified nurse-midwife (CNM)
deliveries
certified respiratory care practitioner
clinician-directed care coordination services (THSteps-CCP only)
DME
durable medical equipment supplier
forms
Addendum to Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form 1 2
Ambulance Fax Cover Sheet
Donor Human Milk Request Form
Extended Outpatient Psychotherapy/Counseling Request Form
External Insulin Pump
Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form
Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form Instructions
Home Health Services Plan of Care (POC)
Home Health Services Plan of Care (POC) Instructions
Home Health Services Prior Authorization Checklist
Medicaid Certificate of Medical Necessity for Chest Physiotherapy Devices
Extended Request
Initial Request
Medicaid Certificate of Medical Necessity for CPAP/BiPAP or Oxygen Therapy
Medicaid Certificate of Medical Necessity for Reduction Mammaplasty
Medical Necessity for In-Home Total Parenteral Hyperalimentation
PCCM
Inpatient/Outpatient Authorization Form
Physician's Medical Necessity Certification for Nonemergency Ambulance Transports
Psychiatric Hospital Inpatient Initial Admission Request Form
Psychiatric Inpatient Extended Stay Request Form
Pulse Oximeter Form
Radiology Prior Authorization Request Form
Request for Extension of Outpatient Therapy (Form TP-2)
Request for Initial Outpatient Therapy (Form TP-1)
Texas Medicaid Prior Authorization Request Form
Intrathecal Baclofen or Morphine Pump Sections I and II
THSteps
ECI Request for Outpatient Therapy
THSteps Dental Mandatory Prior Authorization Request Form
THSteps-CCP Prior Authorization Private Duty Nursing 4 or 6 Month Authorization
THSteps-CCP Prior Authorization Request Form
TPN
gene mutation analysis
hearing aids
home health services
in-home total parenteral hyperalimentation
mandatory prior authorization (dental)
orthodontic services
orthotic and prosthetic suppliers
outpatient behavioral health services
outpatient mental health services
PCCM
outpatient prior authorization
personal care services
physical therapists
private duty nursing
programmable pumps
RSV prophylaxis
speech-language pathologists
telephone numbers
THSteps and ICF-MR dental prior authorization
THSteps-CCP
tissue transplant services
transplants
transport
emergency out-of-state
private duty nursing
client eligibility
Private duty nursing (THSteps-CCP)
claim form example
enrollment 1 2
Procedure codes
contact lenses
CPT
HCPCS codes
LCSW
levels of codes
noncovered
organ transplant prior authorization
orthodontic
portable X-ray suppliers
psychiatric
radiological and physiological laboratories
THSteps dental
tuberculosis
Professional providers
reimbursement
Program for Amplification for Children of Texas
participants
Program for Amplification for Children of Texas (PACT)
referrals
Programmable pumps
prior authorization
Prolonged physician services
Prosthodontics
fixed
removable
Provider
education
out-of-state
professional organizations
resolution of problems
provider enrollment
OB-GYN providers
Provider enrollment
application
Disclosure of Ownership and Control of Interest Statement
family planning
group practices
Medicaid Audit Information Form
PCCM
miscellaneous provisions
termination/disenrollment
provider agreement
required forms
STAR and STAR+PLUS Programs
THSteps Program
Title V, X, and XX Family Planning
Title XIX Family Planning
Provider Relations, TMHP
Provider responsibilities
billing clients
billing requirements
certification
child support
compliance with
Americans with Disabilities Act of 1990
Civil Rights Act of 1964
Rehabilitation Act of 1973
confidential information
incidental services
medical record documentation requirements
patient acknowledgment statement
procedures for reporting
abuse or neglect
suspected sexual abuse
retention of records
training
utilization control
Provider-specific encounter rates
Psychiatric hospital (THSteps-CCP)
claims filing
claim form example
enrollment 1 2
reimbursement
Psychiatric services
chemical dependency treatment
psychological testing, prior authorization for
Psychologist
benefits and limitations
claims filing
claim form example 1 2
documentation required
encounter limit
enrollment
neuropsychological testing
psychological testing
reimbursement 1 2
therapy
Public health districts contacts
Pulse oximeter
Pulse oximetry
Pump implantation
Pumps
implantation
Q
Qualified Medicare Beneficiary (QMB) 1 2 3
client eligibility
R
Radiation services
Radiation therapy
claim form example
clinical treatment planning 1 2
medical radiation physics, special services
Radiological and physiological laboratory and portable X-ray supplier
benefits and limitations
cardiac blood pool imaging
claims filing
claim form example 1 2
diagnosis requirements for other services
enrollment
Medicaid Managed Care Program enrollment
reimbursement
Radiological laboratory
reimbursement
Radiology
family planning
Radiology services 1 2 3
contrast material/radiopharmaceuticals
diagnosis requirements
Rapid plasma reagin
Reasonable cost/interim rates
Record retention
rural health clinic
SHARS
Reduction mammoplasties
Referrals
Case Management for Children and Pregnant Women (CPW)
dental
developmental assessment
family planning
genetic services
mental health
PCCM
Program for Amplification for Children of Texas (PACT)
THSteps 1 2
THSteps dental
Reflux slings, wedges
Refunds 1 2
Registered nurse
THSteps
additional education requirements
Rehabilitation
Rehabilitation hospital (freestanding) (THSteps-CCP)
claims filing
claim form example
reimbursement
Reimbursement
clinician-directed care coordination services (THSteps-CCP only)
personal care services
private duty nursing
RSV prophylaxis
Reimbursement methodology
ambulatory surgical center
birthing center
case management
for children and pregnant women
for children who are blind and visually impaired
certified nurse-midwife
certified registered nurse anesthetist
certified respiratory care practitioner
chemical dependency treatment facility
chiropractic services
clinical nurse specialist
dental
drugs/biologicals
family planning services
genetic services
hearing aid and audiometric evaluations
home health services
hospitals
in-home total parenteral hyperalimentation
independent laboratory
independent practitioners
Indian Health Services
licensed clinical social worker
licensed marriage and family therapist
licensed professional counselors
maternity service clinic
mental health
mental retardation
nurse practitioner
opticians
optometrists
physical therapists
physician
physician assistant
portable X-ray supplier
psychologist
radiological and physiological laboratory
renal dialysis facility
school health and related services
stale-date check process
targeted case management
for early childhood intervention
TB clinics
THSteps
THSteps-CCP CORFs
THSteps-CCP DME
vision care
Remittance and Status (R&S) report
adjustments to claims
banner pages
claims in process
explanation of columns 1 2
explanation of headings
financial items
internal control number (ICN)
paid or denied claims
provider inquiries
title pages
see banner pages
Renal dialysis facility
annually
benefits and limitations
CAPD and CCPD support
claims filing
claim form example (CAPD/CCPD)
CMS-1500 example
enrollment
every month
every six months 1 2
every three months 1 2
hemodialysis, IPD, CCPD, and CAPD training
in-facility dialysis
nonroutine laboratory
routine laboratory
kidney transplants
maintenance hemodialysis
maintenance IPD
once a month
per dialysis
per month
per week
reimbursement 1 2
renal dialysis
revenue codes
services
STAR and STAR+PLUS enrollment
Renal disease
acute
chronic
erythropoietin alfa (EPO)
Repair of durable medical equipment (DME)
THSteps
Repairs to client-owned equipment
Replacement of DME
Replacement of equipment/accessories
Reporting abuse of children or adolescents
Reservoirs
impantation
Respiratory care
Respiratory equipment
Respiratory syncytial virus (RSV) prophylaxis
Retisert
Retroactive eligibility
see Client eligibility
Rho(D) immune globulin
Rider 14 (formerly Rider 18)
see Abuse
Rituximab
Root canal therapy
RSV
RSV prophylaxis
Rural health clinic
family planning services
Rural health clinic (RHC)
benefits and limitations
claim form example
freestanding
freestanding, immunization
hospital-based
claims information
cost report submission
enrollment
freestanding
hospital
Medicaid Managed Care enrollment
record retention
reimbursement
telemedicine services
S
Sacral nerve stimulators
Sargramostim
School Health and Related Services (SHARS)
audiology 1 2
benefits and limitations
billing units
based on 15 minutes
based on an hour
certification of funds
claim form example
claims filing
claim form example
claims information
cost reconciliation and cost settlement
cost reporting
counseling services
eligibility verification
enrollment
evaluation/assessment and psychological services
nonschool SHARS provider enrollment
nursing services
occupational therapy
other insurance
overview
personal care services
physician services
private school enrollment
record retention
reimbursement 1 2
reimbursement and certification of funds
school enrollment
speech therapy
provider and supervision requirements
transportation services in a school setting
Scooters
THSteps-CCP
Screening services
alcohol and drug
depression and suicide risk
guideline for mental health
hyperlipidemia 1 2
lead
sensory screening
hearing screening
sexually transmitted diseases
tuberculosis
Second opinions
Secretion clearance devices
Self-dialysis
Sensory screening
hearing screening
vision screening
Sexual abuse 1 2
Sexual behavior 1 2
Sexually transmitted diseases (STD)
chlamydia
gonorrhea
screening procedures
SHARS
personal care services and
Signature
client
physician (THSteps-CCP)
CORF
DME suppliers
licensed dietitian
occupational therapists
orthotic and prosthetic suppliers
pharmacists
physical therapists
speech-language pathologists
provider 1 2 3
Silver nitrate applicators
Smokeless tobacco
Special needs car seats 1 2
Special needs travel restraints
Specimen Submission Form G-1C, Maternal Serum Prenatal Triple Screen, Spanish Instructions
Speech-language pathologists (THSteps-CCP)
claims filing
claim form example
enrollment 1 2
physician signature
prior authorization
reimbursement
Speech-language therapy 1 2
Spend down
Medically Needy Program
Standers
Standing frame/brace
STAR Program
benefits
adult well check
prescription drugs
spell of illness
claims filing
client enrollment
automatic re-enrollment
newborns
pregnant women
enrollment
THSteps
THSteps-CCP 1 2
HMO model
overview
service areas
STAR+PLUS Program
benefits
claims filing
client eligibility
dual eligible clients
ineligible clients
HMO model
overview
service area
State Legalization Impact Assistance Grant (SLIAG)
Statutory requirements
communicable disease reporting
early childhood intervention (ECI)
newborn blood screening
newborn screening
parental accompaniment
reporting abuse and neglect
simplified enrollment
teen confidentiality issues
Statutory state requirements
communicable disease reporting
early childhood intervention (ECI)
newborn blood screening
parental accompaniment
reporting abuse and neglect
STD testing
Stem cell transplants 1 2
sterilization
Title X
Sterilization
consent form 1 2
attachment to claims
family planning
services
sterilization consent form, instructions
Strollers
Strontium-89
Suicide
Supplemental Security Income (SSI)
Surgery 1 2
anesthesia administered by surgeon
assistant surgeons
bilateral procedures
biopsy
claim form example
claims filing
claim form example
cosurgery 1 2
global fees
global surgery concurrent care
multiple 1 2
office procedures
orthopedic hardware
primary
prostate
second opinions
suture of wounds
team
Synagis (palivizumab)
Syphilis
Syphilis testing
T
Tax Equity and Fiscal Responsibility Act (TEFRA) 1 2
hospitals reimbursed
TB
see Tuberculosis
Teen group counseling
family planning
TEFRA
see Tax Equity and Fiscal Responsibility Act (TEFRA)
Telemedicine
hub site provider
remote site provider
Telephone appeals
Telephone numbers
Department of Assistive and Rehabilitative Services (DARS), Blind Services
DSHS
federal and state
HHSC
client communication
Medicaid eligibility staff
PCCM
community health services
member helpline
nurse line
provider helpline
prior authorization
STAR Help Line
STAR Program
Texas Commission for the Blind
THSteps-CCP
HHSC client contact number
TMHP
Tetanus
Texas Band of Kickapoo Equity Health Program
Texas Board of Nursing (BON)
Texas Department of Family and Protective Services
Texas Health Steps (THSteps)
AAPD Periodicity Guidelines
administrative information
adolescent
eating disorders 1 2
anticipatory guidance
assistance contacts
CCP
communicating with
cervical cancer screening
claims filing
claim form example (medical check up)
diagnosis and treatment claim form example
client eligibility
clinical information
Comprehensive Care Program (CCP)
apnea monitor electrodes
benefits
benefits for children
claim filing resources
client eligibility
CORF benefits and limitations
CORF claims filing
CORF physician signature
corner chairs
corrective shoes
croup tent
DME accessories
DME adjustments
DME benefits and limitations
DME enrollment
DME mobility aids
DME mobility aids coding
DME mobility aids limitations
DME modifications
DME policies
DME prior authorization/documentation
DME reimbursement
DME repairs
DME supplier
donor human milk
Early Childhood Intervention (ECI)
ECI claims information
ECI program revisions
ECI services
electronic blood pressure monitoring device
enclosed beds
enrollment
feeder seats
fittings of orthosis/prostheses
floor sitters
incontinence supplies (DME)
licensed dietitians
limitations 1 2
medical nutritional products
modifications of orthosis/prostheses
occupational therapy services
orthotic and prosthetic
repairs
replacement
suppliers
training
parapodium
pediatric hospital cribs
pharmacist
eligibility
physician signature
reimbursement
physical therapist
claims filing
reimbursement
physical therapy services
physician signature
CORF
prior authorization
private duty nursing
procedure codes
psychiatric hospital
pulse oximeter
reciprocating gait orthoses
referrals
rehabilitation hospital (freestanding)
removable shoe insert
respiratory care equipment
coding
limitations
scooters
special needs car seats
speech therapy services
standing frame/brace
STAR enrollment
strollers
Thoracic-hip-knee-ankle orthoses (THKAO)
travel chairs
travel restraints
vertical stander
wedge and lift
continuity of care
dental
eligibility
emergency dental referrals
patient education
referrals
routine dental referrals
screening
services
Dental Guidelines
developmental screening
early childhood caries
exceptions to periodicity
forms
see Forms
health education
hearing referrals
hearing screening
4 years of age and older
birth-3 years of age
initial test at birth
puretone audiometer
hearing services
immunizations
consent form
laboratory services
laboratory supplies
medical check up
additional required laboratory tests for adolescents
adolescent physical
birth through 9 years of age
body mass index (BMI)
confidentiality
documentation
eligibility
exception to periodicity
facilities
first 6 days of life
health education/anticipatory guidance
hearing screening
laboratory
laboratory procedures
measurements
mental health screening
newborn eligibility
nutritional screening
periodicity schedule, 10-20 years of age
periodicity schedule, birth-9 years of age
physical
referral
STD screening procedures
verification
medical home concept
mobile units
newborn
eligibility
hearing screening
required components of examination
newborn examination
parental accompaniment
periodicity exceptions
periodicity schedules
provider enrollment
Quick Reference Guide 1 2
referrals
registered nurse
additional education requirements
reimbursement
newborn examination
required laboratory screening procedures
sensory screening
hearing screening 1 2
vision screening
STAR Program enrollment
statutory requirements
STD testing
Texas Health Steps Statutory State Requirements
tuberculosis testing
in high-prevalence areas
vision screening
supplies
vision services
Texas immunization registry
Texas Kidney Health Care Program
Texas Medicaid & Healthcare Partnership (TMHP)
Texas Medicaid Program
administration
Texas Medicaid reimbursement 1 2
Texas Medical Assistance Program (Medicaid)
Texas Medical Review Program (TMRP)
Texas Vaccines for Children (TVFC) Program 1 2 3
Vaccine Information Statement (VIS)
TexMedConnect
training
The Stewart McKinney Act
Therapeutic apheresis
Therapeutic phlebotomy
Third Party Resources
dental
managed care
Third Party Resources (TPR)
110-day rule
accident-related claims
adoption cases
claims filing
confidentiality
filing deadlines
Medicaid Identification (Form H3087)
nonsources
refunds
sources
verbal denial
Workers' Compensation
Third-party insurance
family planning
Thoracic-hip-knee-ankle orthoses (THKAO)
Thymoglobulin
Thyrogen
Title X family planning claims
TMHP
Contact Center
TMHP EDI
appeal submission
avoiding delays and rejections
Help Desk
newborns
TMHP Provider Relations
TMHP website
Tobacco use 1 2 3
adolescent
dental referral
Tooth identification (TID) number
Topotecan
Total parenteral nutrition
see also In-home total parenteral hyperalimentation supplier
Transfers
client transfers
Transplants
heart 1 2 3
intestinal
kidney 1 2
liver 1 2
lung 1 2
services
stem cell 1 2
transplant center approval
Trastuzumab
Travel chairs
Travel restraints
Trial injection 1 2
Trovan
Tubal ligation
family planning
Tuberculosis
adolescent testing
benefits
chest X-ray procedure codes
claims filing
claim form example
classification system for TB
diagnosis codes
DOT/DOPT examination
enrollment
follow-up examination
initial examination
monthly examination
place of service
procedure codes 1 2 3
provider responsibilities
reimbursement 1 2
testing
in high-prevalence area
Type of service (TOS) 1 2
U
UB-04 CMS-1450
claim form paper billing
electronic billing
instruction table
occurrence codes
Undocumented aliens 1 2
Urinalysis
Utilization review
admission review
dental
process, hospital
quality review
V
Vagal nerve stimulators
Valrubicin
see Valstar
Valstar
Vaporizers
Vasectomy
family planning
Vendor Drug 1 2 3
Ventilator service agreement
Verification of medical check ups
Vertical stander
Vestibuloplasty
Vision
benefits and limitations
claims filing
claim form example
contact lenses 1 2
services not covered
corneal topography
diagnosis codes
echography
enrollment
eye exams
prescribing eyewear
eye injury
eyeglasses
frames
lenses 1 2
Medicare coverage
noncovered services
nonprosthetic eyewear
opticians
optometrists
prosthetic eyewear
provider responsibility
refractive errors
reimbursement 1 2
replacements 1 2
screening 1 2
2-4 years of age
birth-2 years of age
newborns
supplies
significant diopter change
STAR and STAR+PLUS enrollment
therapeutic optometrists
THSteps
Vitamin B12
see Cyanocobalamin
Volume ventilators
W
Waiver certificate
independent laboratory
Western blot
Wheelchair
levels
Wheelchair ramp (portable and threshold)
Women, Infants, and Children (WIC)
Women's Health Program 1 2
Workers' Compensation 1 2
Wound care
supplies
systems
X
X-ray
chest
procedures by podiatrist
tuberculosis
Z
Zylonite frames
  
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