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December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 3 Case Management for Children and Pregnant Women : 3.1 Overview : 3.1.1 Eligibility

3.1.1
To be eligible for services, a person must:
Pregnant women who have a high-risk condition are defined as those who have a medical or psychosocial condition that places them and their fetuses at a greater than average risk for complications, either during pregnancy, delivery, or following birth. Children with a health condition are defined as children who have a health condition or health risk or children who have or are at risk for a medical condition, illness, injury, or disability that results in the limitation of function, activities, or social roles in comparison with healthy same-age peers in the general areas of physical, cognitive, emotional, or social growth and development.

Texas Medicaid & Healthcare Partnership
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