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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