TMPPM 2008 > Texas Medicaid Services > Independent Laboratory > Reimbursement

26.3.1 Texas Health Steps (THSteps) Outpatient Laboratory Services

The Medicaid service, Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), is known in Texas as Texas Health Steps (THSteps).

Refer to: "Eligibility for a Medical Check Up" .

All required THSteps laboratory work is to be performed by the Department of State Health Services (DSHS) Laboratory Services Section. DSHS makes these services available free to all enrolled THSteps medical providers for THSteps clients. THSteps services provided in a private laboratory will not be reimbursed. The Laboratory Services Section is reimbursed at its cost for performing these tests.

Except for Pap smears, all required THSteps laboratory work that can be mailed at ambient temperature must be sent to the DSHS Laboratory Services Section using the business reply label provided to the following address:

DSHS Laboratory: Walter Douglass
PO Box 149163
Austin, TX 78714-9803

THSteps laboratory work requiring shipping overnight on cold packs through a courier service must be sent to the DSHS Laboratory Services Section at the following address:

DSHS Laboratory Services Section
1100 West 49th Street
Austin, TX 78756-3199
1-512-458--7318
Fax: 1-512-458-7294
Toll-free: 1-888-963-7111 ext. 7318.

Pap smear specimens must be sent to the following address:

Women's Health Laboratories
2303 SE Military Drive, Suite 1
San Antonio, TX 78223
Customer Service: 1-888-440-5002 or 1-210-531-4596
Fax: 1-210-531-4506

Claims for tests listed in the following table submitted by a THSteps medical provider or an outside laboratory for the same date of service as a THSteps medical check up will be denied and are subject to retrospective review and recoupment of inappropriate payments.

Texas Health Steps (THSteps) medical providers may choose the laboratory to which they send THSteps laboratory specimens for blood test screening for hyperlipidemia or Type 2 diabetes (procedure codes 5-80061, 5-82465, 5-82947, 5-82952, 5-83718, and 5-84478).

Blood specimens for the above tests collected as part of the THSteps medical check up may be sent to the provider's laboratory of choice.

Laboratories that bill for these procedure codes on the same date of service as a medical check up visit can be reimbursed separately.

Providers who obtain and process these specimens in-house are not reimbursed separately.