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CSHCN Services Program Provider Manual

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The CSHCN Services Program Provider Manual was updated on November 15, 2024, and contains all policy changes through November 1, 2024. The manual is available in both PDF and HTML formats.

See the release notes for detailed information on the changes.

For previous editions of the manual, visit the manual archives.

November 2024 CSHCN Services Program Provider Manual
Complete BookIndividual Chapters

Complete Book (HTML)

Complete Book (PDF)

Table of Contents
Introduction
Chapter 1: TMHP and HHSC Contact Information
Chapter 2: Provider Enrollment and Responsibilities
Chapter 3: Client Benefits and Eligibility
Chapter 4: Prior Authorizations and Authorizations
Chapter 5: Claims Filing, Third-Party Resources, and Reimbursement
Chapter 6: Remittance and Status (R&S) Reports
Chapter 7: Appeals and Administrative Review
Chapter 8: Advanced Practice Registered Nurse (APRN [NP/CNS])
Chapter 9: Ambulance
Chapter 10: Augmentative Communication Devices (ACDs)
Chapter 11: Blood Pressure Monitoring and Devices
Chapter 12: Certified Registered Nurse Anesthetist (CRNA)
Chapter 13: Certified Respiratory Care Practitioner (CRCP)
Chapter 14: Dental
Chapter 15: Diabetic Equipment and Supplies
Chapter 16: Diagnostic Radiology Services
Chapter 17: Durable Medical Equipment (DME)
Chapter 18: Expendable Medical Supplies
Chapter 19: Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC)
Chapter 20: Hearing Services
Chapter 21: Home Health Services
Chapter 22: Home Health (Skilled Nursing) Care
Chapter 23: Hospice
Chapter 24: Hospital 
Chapter 25: Laboratory Services
Chapter 26: Medical Nutrition Services
Chapter 27: Neurostimulators and Neuromuscular Stimulators
Chapter 28: Orthotic and Prosthetic Devices
Chapter 29: Outpatient Behavioral Health
Chapter 30: Physical Medicine and Rehabilitation
Chapter 31: Physician
Chapter 32: Physician Assistant (PA)
Chapter 33: Prescribed Pediatric Extended Care Centers
Chapter 34: Radiation Therapy Services
Chapter 35: Renal Dialysis
Chapter 36: Respiratory Equipment and Supplies
Chapter 37: Speech-Language Pathology (SLP) Services
Chapter 38: Telecommunication Services
Chapter 39: Transportation of Deceased Clients
Chapter 40: Vision Services
Chapter 41: TMHP Electronic Data Interchange (EDI)
Appendix A: Acronyms and Initialisms Dictionary