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2012 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 5. THSteps Medical : 5.3 Services, Benefits, Limitations, and Prior Authorization : 5.3.6 Follow-up Medical Checkup

5.3.6
Use procedure code 99211 with the THSteps provider identifier and THSteps benefit code when billing for a follow-up visit.
Note:
A follow-up visit may be required to complete necessary procedures related to a THSteps medical checkup or exception-to-periodicity checkup, such as:
Administering immunizations in cases where the client's immunizations were not up-to-date, medically contraindicated, or unable to be given on the initial visit.
A return visit to follow up on treatment initiated during a checkup or to make a referral is not a follow-up visit, but is considered an acute care visit under an appropriate E/M procedure code for an established client.
If the parent or guardian did not give consent for a component during the initial checkup, and supporting documentation is provided, no follow-up visit is necessary.

Texas Medicaid & Healthcare Partnership
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