TMPPM 2011 > Children's Services Handbook > THSteps Medical > Enrollment > THSteps Medical Provider Enrollment

5.2 Enrollment

5.2.1 THSteps Medical Provider Enrollment

To provide THSteps medical checkups, providers must be enrolled in Texas Medicaid and must be one of the following:

•A physician (doctor of medicine [M.D.] and doctor of osteopathy [D.O.]) who is currently licensed in the state where the service is provided

•A rural health clinic (RHCs) or federally qualified health center (FQHC)

•A health-care provider or facility (public or private) that is capable of performing the required medical checkup procedures under a physician's direction, such as a regional or local health department, family planning clinic, migrant health clinic, community-based hospital or clinic, maternity clinic, home health agency, or school district. In the case of a clinic, a physician is not required to be present in the clinic at all times during the hours of operation; however, a physician must assume responsibility for the clinic's operation.

•An APRN who is recognized by the Texas BON and nationally certified to perform in at least one of the following areas of practice:

•Pediatrics

•Family practice

•Adult health (adolescents only)

•Women's health (adolescent females only)

•Certified nurse midwife (newborns and adolescent females only)

•Physician assistants (PAs)-It is recommended that PAs have expertise or additional education in the areas of comprehensive pediatric assessment.

Residents may provide medical checkups in a teaching facility under the personal guidance of the attending staff as long as the facility's medical staff by-laws and requirements of the Graduate Medical Education (GME) Program are met, and the attending physician has determined the intern or resident to be competent in performing these functions. THSteps does not require the supervising physician to examine the client as long as these conditions are met.

An RN without an advance practice certification may not enroll independently, but may perform THSteps medical checkups only under the supervision of a physician. The physician ensures that the RN has appropriate training and adequate skills for performing the procedures for which they are responsible.

Providers cannot be enrolled if their professional license is due to expire within 30 days of application. Facility providers must submit a current copy of the supervising practitioner's license. To provide Medicaid services, each nurse practitioner (NP) must be licensed as a registered nurse (RN) and recognized as an advanced practice registered nurse (APRN) by the Texas Board of Nursing (BON).

Refer to: Subsection 1.1, "Provider Enrollment" in Section 1, "Provider Enrollment and Responsibilities" (Vol. 1, General Information) for information about enrollment procedures.