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.
Effective for dates of service on or after June 1, 2021, new screening tools, one for developmental screenings for children and another for mental health screenings for adolescents, will be added for Texas Health Steps Preventive Care Medical Checkups.
The Survey of Well-being of Young Children (SWYC) will be added as a recognized developmental screening tool for children at 9 months, 18 months, 24 months, 3 and 4 years of age, as well as through 6 years of age if not completed previously.
The Rapid Assessment for Adolescent Preventive Services (RAAPS) will be added as a recognized mental health screening tool for adolescents who are 12 through 18 years of age.
Providers may refer to the current Texas Medicaid Provider Procedures Manual, Children’s Services Handbook, subsection 126.96.36.199.2, “Developmental Surveillance or Screening,” and subsection 188.8.131.52.3, “Mental Health Screening,” for additional information.
For more information, call the TMHP Contact Center at 800-925-9126.