Table of Contents Previous Next Index

2012 Texas Medicaid Provider Procedures Manual

Gynecological and Reproductive Health and Family Planning Services Handbook : 3. Women’s Health Program (Title XIX Family Planning) : 3.3 Services, Benefits, Limitations, and Prior Authorization : 3.3.8 Sterilization and Sterilization-Related Procedures : Sterilization Consent
Per federal regulation 42 Code of Federal Regulations (CFR) 50, Subpart B, all sterilization procedures require an approved Sterilization Consent Form.
Refer to:
Form GN.3, “Sterilization Consent Form (Spanish)” in this handbook.
Form GN.1, “Sterilization Consent Form Instructions (2 pages)” in this handbook.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2011 American Medical Association. All rights reserved.