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Texas Health Steps and CSHCN Services Program Dental Therapy Forms Revised

Last updated on 4/26/2021

Effective June 1, 2021, the Criteria for Dental Therapy Under General Anesthesia form (applicable for Texas Health Steps dental providers) and the Children with Special Health Care Needs (CSHCN) Services Program Criteria for Dental Therapy Under General Anesthesia form will be modified to include the Spanish translation in the client behavior and certification sections.

Reminder: Parents or guardians must sign the form indicating they have read and agree with the dentist’s assessment regarding their child’s behavior as indicated in the client behavior section of the form.

Texas Health Steps dental providers and CSHCN Services Program dental providers will see the changes reflected in the revised version of both forms beginning June 1, 2021.

Previous versions of the forms will continue to be accepted until July 1, 2021. Beginning July 1, 2021, only the new version of the form will be accepted. Providers should use the updated version only. Beginning on or after July 1, 2021, if a request is received using the outdated version of the form, the request will be returned to the provider with a letter that will inform the provider to submit a current form.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.