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December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 6 Physician, Psychologist, and Licensed Psychological Associate (LPA) Providers : 6.2 Services, Benefits, Limitations, and Prior Authorization

Behavioral health services, including diagnostic evaluations, psychotherapy or counseling (including individual, group, or family counseling), psychological and neuropsychological testing, and pharmacological management are benefits of Texas Medicaid when these services are provided to clients who are experiencing a significant behavioral health issue that is causing distress, dysfunction, or maladaptive functioning as a result of a confirmed or suspected psychiatric condition, as defined in the most current edition of the DSM.

Texas Medicaid & Healthcare Partnership
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