Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.
Texas Health Steps recognizes the critical importance of routine preventive medical and dental checkups for Texas children. However, during this challenging time, Texas Health Steps encourages medical and dental providers to make decisions on adjusting their clinical operations based on their professional medical judgement and/or guidance from their professional medical and dental societies. This should include considering the risk of exposure to COVID-19 (coronavirus) at the local and community level. These adjustments may include the decision to do the following:
- Temporarily postpone certain check-ups
- Limit check-ups to certain times of the day
- Dedicate specific rooms for sick visits and well visits
- Prioritize visits for younger children, especially those due for routine vaccines
Providers are encouraged to continue providing in-person medical exams for children entering Department of Family and Protective Services (DFPS) conservatorship (“3-day exam”). This is an opportunity to have a child new to DFPS conservatorship be seen by a health care provider and for the new caregiver to have information about the child’s health as these medical visits are very important.
Please visit the professional society websites below for more information on COVID-19:
- American Academy of Pediatrics: services.aap.org/en/pages/covid-19-clinical-guidance-q-a/
- American Dental Association: www.ada.org/en/member-center/coronavirus-resource-toolkit-for-ada-members
The Health and Human Services Commission will provide future guidance around flexibility related to compliance with timeliness requirements.
For more information, call the TMHP Contact Center at 800-925-9126.