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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 : 3.3 Services, Benefits, Limitations, and Prior Authorization : 3.3.1 Prior Authorization

All services must be prior authorized. One comprehensive visit is approved for all eligible clients. Follow-up visits are authorized based on contributing factors. Additional visits can be requested and may be authorized based on a continuing need for services. A prior authorization number is required on all claims for Case Management for Children and Pregnant Women services.
Approved case management providers may submit requests for prior authorization from DSHS on the DSHS website at

Texas Medicaid & Healthcare Partnership
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