Table of Contents Previous Next

December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 3 Case Management for Children and Pregnant Women : 3.2 Enrollment

3.2
Enrollment for Case Management for Children and Pregnant Women providers is a two-step process.
Step 1
Potential providers must submit a Department of State Health Services (DSHS) Case Management for Children and Pregnant Women provider application to the DSHS Health Screening and Case Management Unit.
Both registered nurses who have an associate’s, bachelor’s, or advanced degree and social workers who have a bachelor’s or advanced degree are eligible to become case managers if they are currently licensed by their respective Texas licensure boards and the license is not temporary in nature. Registered nurses with associate degrees must also have at least two years of cumulative, paid, full-time work experience or two years of supervised full-time, educational, internship/practicum experience in the past ten years. The experience must be with pregnant women or with children who are 20 years of age and younger. The experience must include assessing psychosocial and health needs and making community referrals for these populations. Registered nurses with bachelor or advance degrees and social workers do not have to meet any experience requirements.
For more information about provider qualifications and enrollment, contact DSHS at 1-512-458-7111, Ext. 2168, visit the case management website at www.dshs.state.tx.us/caseman/default.shtm, or write to the following address:
Department of State Health Services
Case Management for Children and Pregnant Women
PO Box 149347, MC 1938
Austin, TX 78714-9347
Note:
Step 2
Upon approval by DSHS, potential providers must enroll as a Medicaid provider for Case Management for Children and Pregnant Women and submit a copy of their DSHS approval letter. Facility providers must enroll as a Case Management for Children and Pregnant Women group, and each eligible case manager must enroll as a performing provider for the group. Federally Qualified Health Center (FQHC) facilities that provide Case Management for Children and Pregnant Women services will use their FQHC number and should not apply for an additional provider number for Case Management for Children and Pregnant Women.
Refer to:
Subsection 1.1, “Provider Enrollment and Reenrollment” in Section 1, “Provider Enrollment and Responsibilities” (Vol. 1, General Information) for more information about the procedures for enrolling as a Medicaid provider.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.