Overview
The Texas Health Steps (THSteps), formerly known as Early and Periodic Screening, Diagnosis and Treatment program, is specifically a children's program under Medicaid which provides medical and dental preventive care and treatment to Medicaid-enrolled children from birth to 21 years of age. THSteps 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 THSteps Outreach
- arrange transportation or reimbursement for gas money to see a doctor or dentist
- answer questions about eligible services.
The following are some of the services provided by the THSteps program:
THSteps Resources on the TMHP Website
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THSteps Forms
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THSteps Contact Information
- 1-877-THSTEPS (DSHS): 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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THSteps Helpful Links:
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Periodic Medical Check-ups and Services
THSteps provides medical check-ups and preventive services for Medicaid recipients
under the age of 21 at no cost. Services are provided on a Periodicity Schedule
that reflects when each of the components of the check-up, immunizations, laboratory
tests, hearing and vision screening, etc., are due from birth through age 20.
The THSteps medical screening and prevention services provide the following:
- History – Before the unclothed physical examination is performed, the child's history is taken and includes documenting the family and neonatal histories as well as the child's physical and mental health and development, immunizations, feeding and nutrition, and a complete review of body systems.
- Physical Examination – A complete physical exam is required at each visit.
- Measurements – Height (3-20 years of age), weight (0-20 years of age), length (0-2 years of age), and Body Mass Index (10-20 years of age) are taken and compared with national standards to identify significant deviations from the norm.
- Nutritional Assessment - Dietary practices are assessed to identify unusual eating habits and to help determine quality and quantity of the child's nutritional intake.
- Developmental Assessment - A developmental assessment must be performed for each age group based on the physician's personal preference of tests or review of developmental milestones.
- Sensory Screening - A vision and hearing screening is conducted and completed according to the requirements in the Texas Medicaid Provider Procedures Manual.
- Laboratory Screening - Several laboratory tests (such as total hemoglobin, hematocrit, HDL cholesterol, and others) help assess the total health of the child.
- Health Education/Anticipatory Guidance - Health education
is a mandatory part of the medical check-up. Health education and counseling
face-to-face with parent(s) or guardian(s) and children helps them understand
what to expect in the child's development and provides information about the
benefits of healthy lifestyles and practices, as well as accident and disease
prevention.
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Dental Check-ups and Treatment Services
THSteps and the Texas Medicaid Program 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 THSteps, 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:
- 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.
Prior Authorized Orthodontic Services, including:
- 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, without a formal THSteps check-up.
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Private-Duty Nursing (PDN)
Private-Duty Nursing (PDN) is part of the Texas Health Steps – Comprehensive Care Program (THSteps-CCP) which supports families in the care for children who have serious health care needs and promotes family-centered, community based care for their children. For more information, please visit the Department of State Health Services (DSHS) website for THSteps.
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Laboratory Services
The Texas Department of State Health Services (DSHS) Laboratory processes tests at no charge to the provider. Lab test results are mailed back 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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