Texas Health Steps
How It Works

Checkups and a Whole Lot More!

• Qualified medical and dental providers enroll in Medicaid and indicate on the enrollment form that they will be providing Texas Health Steps services.



• A nine-character Texas Provider Identifier (TPI) is issued to the provider by the Claims Administrator (Texas Medicaid & Healthcare Partnership). This identifier is very important since it is used when filing claims for reimbursement for providing Texas Health Steps services.



• Locally field-based Texas Medicaid & Healthcare Partnership (TMHP) Medicaid Provider Relations Representatives are available to assist and train Medicaid providers. These Provider Relations Representatives provide education and training on claims submission for new and existing Medicaid providers. Technical support and training also are provided for TDHconnect software users. To find how and where to request this type of assistance and training, visit the TMHP Regional Support web page. In addition regionally-based Department of State Health Services (DSHS) Texas Health Steps (THSteps) Provider Relations Representatives are available to respond to Medicaid providers' questions and problems. To find how and where you may request this type of assistance, visit the DSHS THSteps Regional web page.



• Texas Health Steps Outreach and Informing staff contact newly enrolled Texas Health Steps recipients to inform them of the services to which they are entitled; to encourage them to use the Texas Health Steps preventive medical and dental check-up services; to provide them with a list of all Texas Health Steps providers in their area, and; to assist them in setting an appointment for a medical and/or dental check-up.



• At the time of their appointment, recipients present their Medicaid identification form (Form #3087) to their provider and receive their medical and dental check-ups from and establish a medical or dental home with their Texas Health Steps provider. Should additional acute care be needed as a result of the check-up, these services are also provided and providers receive reimbursement for providing them.



• The Provider submits an electronic or paper claim form to the Claims Administrator for reimbursement. Deadlines for submitting claims: 95 days for in-state providers and 365 days for out-of-state providers.



• The Provider receives reimbursement from the Claims Administrator.