Texas Health Steps
Checkup Components

Checkups and a Whole Lot More!

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.