Texas Health Steps
Checkup Components
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Checkups and a Whole Lot More!
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Below is a brief summary of the major components of a medical check-up
that are required as a condition for provider reimbursement by Medicaid
and Texas Health Steps policy. Also listed is the Texas Health Steps Periodicity
Schedule. For details regarding specific checkup and reimbursement requirements,
please visit the Claims Administrator, the Texas
Medicaid & Healthcare Partnership website, and review Chapter
43 of the Texas Medicaid Provider Procedures Manual.
- History
The initial history must be completed and must include the
family medical history, neonatal history (if applicable), the child's
physical and mental health and developmental history, immunization
history, feeding or nutrition problems, and a complete review of body
systems.
- Physical Examination
A complete physical examination is required at each visit
with infants totally unclothed and older children undressed and suitably
draped (see the Periodicity
Schedule on page 43-15 in Section
43 of the Texas Medicaid Provider Procedures Manual).
- Measurements
Height for children 3-20 years, weight for children 0-20
years, length for children 0-2 years must be taken. Body Mass Index
(BMI) for children 2-20 years must be calculated and must be compared
with the National Center for Health Statistics growth charts to identify
significant deviations from norms.
- Nutritional Screening
Dietary practices should be assessed to identify unusual
eating habits such as pica, extended use of baby bottle feedings,
or possible eating disorders in older children and adolescents. Quality
and quantity determination of the recipient's diet should be made.
- Developmental Screening
A developmental screening must be performed for each age
group based on the physician's personal preference of standardized
screening tools.
- Sensory Screening
A vision and hearing screening must be completed according
to the requirements in the Texas Medicaid Provider Procedures Manual,
Section 43.
- Laboratory Screening
Several laboratory tests are required, such as a total hemoglobin,
hematocrit, blood lead level, and others. All laboratory work (with
the exception of screening for hyperlipidemia and type 2 diabetes)
must be performed by the Department of
State Health Services Laboratories. These laboratory services
are provided by DSHS at no cost to the provider. For a complete list
of laboratory services required as a condition of reimbursement, please
see the Texas Medicaid Provider Procedures Manual, Section 43.
- Health Education/Anticipatory Guidance
Health education is a federally mandated component of the
Texas Health Steps medical check-up and includes anticipatory guidance.
Health education and counseling face-to-face with parent(s) or caretaker(s)
and children is required and designed to assist in the understanding
of what to expect in terms of the child's development and to provide
information about the benefits of healthy lifestyles and practices,
as well as accident and disease prevention.
- Texas Health Steps Periodicity
Schedule - 0-20 Years
The Texas Health Steps Periodicity Schedule reflects when
each of the components of the Texas Health Steps check-up is due.
It also contains "Footnotes" that provide clarifications for such
items as the tuberculosis screening, dental referrals, immunizations,
etc. The periodicity schedule also can be found on page 43-16 and
43-17 of the Texas
Medicaid Provider Procedures Manual, Chapter 43 Texas Health Steps.
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