Texas Health Steps, formerly known as Early and Periodic Screening, Diagnosis and Treatment program, is specifically a children's program under Texas Medicaid which provides medical and dental preventive care and treatment to Medicaid clients who are birth through 20 years of age. Texas Health Steps assists eligible recipients and their parents or guardians to:
- Find a qualified medical or dental provider enrolled in Medicaid
- Set up appointments to see a doctor or dentist through Texas Health Steps Outreach
- Arrange transportation or reimbursement for gas money to see a doctor or dentist
- Answer questions about eligible services.
News for Texas Health Steps Providers
Updated AnyConnect VPN Version for EDI Submitters Required by September 1, 2019
Texas Health Steps Quick Reference Guide Updated for
Additional Procedure Code Relationships for CSHCN and Texas Health Steps Dental Restorative Services
Update to Children’s Services Handbook THSteps Medical Checkups
Reimbursement Rate Changes for Procedure Code D2335 to Become Effective
September 1, 2018
Services Provided by Texas Health Steps Providers
The following are some of the services provided by the Texas Health Steps program:
Texas Health Steps Resources on the TMHP Website
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Texas Health Steps Forms
Texas Health Steps Contact Information
- 1-877-THSTEPS (HHSC): 1-877-847-8377
- TMHP General Inquiry: 1-800-925-9126
- Texas Health Steps Dental (TMHP Contact Center):1-800-568-2460
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Texas Health Steps Helpful Links:
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Preventive Care Medical Checkups and Services
Texas Health Steps provides medical checkups and preventive services for Medicaid client’s birth through 20 years of age. Services are provided by Medicaid enrolled Texas Health Steps providers and are based on the Texas Health Steps Periodicity Schedule. The Periodicity Schedule lists specific medical screening components for infants, children and youth and the various ages when
they are required.
Texas Health Steps medical checkups must include regularly scheduled examinations and screenings of the general physical and mental health, growth, development, and nutritional status of infants, children and youth. The following federal and state mandated components must be documented in order for the checkup to be considered complete:
- Comprehensive health and developmental history, including physical and mental health development- A complete history includes family and personal medical history along with nutritional screening, developmental surveillance and screening, and behavioral, social and emotional screening. The Texas Health Steps Tuberculosis Questionnaire is required annually beginning at 12
months of age, with a skin test required if screening indicates a risk of possible exposure.
- Comprehensive unclothed physical examination- A complete exam includes the recording of measurements and percentiles to document growth and development including length or height and weight (0-20 years), fronto-occipital circumference (0-2 years), body mass index (2-20 years) and blood pressure (3-20 years). Oral health screening and hearing and vision screening are also required components of the physical exam.
- Immunizations appropriate for age and health history- Immunization status must be screened at each medical
checkup and necessary vaccines must be administered at the time of the checkup and according to the current ACIP “Recommended Childhood and Adolescent Immunization Schedule-United States,” unless medically contraindicated or because of parental reasons of conscience including religious beliefs.
- Laboratory tests appropriate for age and risk, including lead toxicity at specific federally mandated ages- Required age based laboratory screenings include newborn screening and anemia and lead screening. Risk-based lab screenings include testing for hyperlipidemia, diabetes, and sexually transmitted diseases including HIV,
syphilis and gonorrhea/chlamydia.
- Health education including anticipatory guidance- Anticipatory guidance is a federally mandated component of the medical checkup and health education and counseling is required in order to assist parents, caregivers and clients in understanding what to expect in terms of growth and development. Health education and counseling includes healthy lifestyle practices as well as prevention of lead poisoning, accidents and disease.
- Dental referral- Clients must be referred to establish a dental home beginning at 6 months of age or earlier
if needed. Subsequent referrals must be made until the parent or caregiver confirms that a dental home has been established. The parent or caregiver may self-refer for dental care at any age.
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Dental Checkups and Treatment Services
Texas Health Steps and Texas Medicaid work together to ensure client rights to receive dental services which meet or exceed the standards of care established by the laws relating to the practice of dentistry and the rules and regulations of the Texas State Board of Dental Examiners.
Preventive and maintenance services covered by Texas Health Steps, including:
- dental examinations (initial and periodic)
- cleaning (prophylaxis)
- application of topical fluoride
- application of sealants to certain teeth
- maintenance of space
- oral health education
Treatment services, including:
- restorative treatment (fillings, crowns, etc.)
- endodontic treatment (pulp therapy, root canals, etc.),
- periodontic treatment (gum disease)
- prosthodontics (full or partial dentures)
- oral surgery (extractions)
- implant services and Maxillo-facial prosthetics
Emergency Dental Services, including:
Prior Authorized Orthodontic Services, including:
- procedures necessary to control bleeding, relieve pain, and eliminate acute infection
- operative procedures that are required to prevent imminent loss of teeth
- treatment of injuries to the teeth or supporting structures.
- correction of cleft palate
- provision of orthodontic appliances
- crossbite therapy
- treatment for facial accidents involving severe traumatic deviation
- treatment for severe, handicapping malocclusion
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Comprehensive Care Program (CCP)
The Comprehensive Care Program (CCP) provides medically necessary treatment and treatment for problems identified by a health care professional. Health problems
requiring additional treatment may be identified during a Texas Health Steps medical
checkup or at other visits. For more information about CCP benefits and limitations, providers can refer to the Texas Medicaid Provider Procedures Manual
Children's Services Handbook.
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The Texas Department of State Health Services (DSHS) Laboratory processes tests at no charge to the provider. Laboratory
test results are made available by mail, fax, HL7, or online to the provider to share with the client. To find out which
services are covered, or for more information, please visit the Department of State Health Services (DSHS) Laboratory Services Section website .
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