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Step Into a Healthy Future With Texas Health
Steps!
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About Texas Health Steps
The Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) service
is Medicaid's comprehensive preventive child health service (medical,
dental, and case
management ) for individuals younger than 21 years of age. In Texas
EPSDT is known as the Texas Health Steps (THSteps) Program. EPSDT was
defined by federal law as part of the Omnibus Budget Reconciliation Act
(OBRA) of 1989 legislation and includes periodic screening, vision, hearing,
and dental preventive and treatment services. In addition, Section 1905(r)(5)
of the Social Security Act requires that any medically necessary health
care service listed in the Act be provided to THSteps (EPSDT) recipients
even if the service is not available under the State's Medicaid plan to
the rest of the Medicaid population. These additional services are available
through the Comprehensive Care Program (CCP).
THSteps is dedicated to:
- Expanding recipient awareness of existing medical, dental,
and case management services,
and;
- Recruiting and retaining a qualified provider pool to assure the
availability of comprehensive preventive medical, dental,
and case management services.
Recipients
THSteps is a service under Medicaid. THSteps gives medical and dental
check-ups and care and case management
services to children from birth to age 21 who are enrolled in Medicaid.
THSteps will help you:
- Find a doctor or dentist for your child;
- Set up a time for your child to see a doctor or dentist;
- Get a ride or money for gas to get to a medical or dental appointment, and;
- With any questions you may have about the services your child can get.
Call to find out more about what your child can get
from THSteps
1-877-THSTEPS
1-877-847-8377
(The call is free!)
Providers
- Medical, dental, case
management, and other providers are the cornerstone to making sure
the young people of Texas receive THSteps medical and dental preventive
and treatment services.
- THSteps is committed to providing reimbursement and training and
to recruiting and retaining qualified providers so that these comprehensive
health services are available.
- Providers performing medical, dental,
and case management services
who wish to be eligible for reimbursement for Title XIX (Medicaid and
THSteps) benefits must enroll in these programs through the
Texas Medicaid
& Healthcare Partnership.
- To enroll in the Texas Medicaid and THSteps Medical Program, providers must be a/an:
- Physician (doctor of medicine [MD] and doctor of osteopathy [DO]) currently licensed in the state where the service is provided. Note: Providers cannot be enrolled if their professional license is due to expire within 30 days of application.
- Health care provider or facility (public or private) capable of
performing the required medical checkup procedures under a physician's
direction, such as regional and local health departments, family planning
clinics, migrant health clinics, community-based hospitals and clinics,
maternity clinics (MSCs), rural health clinics (RHCs), federally qualified
health centers (FQHCs), home health agencies (HHAs), school districts,
and family or pediatric nurse practitioners. In the case of a clinic,
a physician is not required to be present in the clinic at all times
during the hours of operation; however, a physician must assume responsibility
for the clinic's operation.
- Physician Assistants, and family and pediatric nurse practitioner
enrolled independently.
- Certified nurse-midwive (CNM) enrolled as a provider of THSteps
medical checkups for newborns younger than 2 months of age and adolescent
females.
- Women's health care nurse practitioner enrolled as a provider of
THSteps medical checkups for adolescent females.
- Adult nurse practitioner enrolled as a provider of THSteps checkups
for adolescents.
- For additional restrictions and educational requirements, please
see the THSteps Section 43 of the Texas
Medicaid Provider Procedures Manual available on the TMHP
web site.
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