Newborn Screening Program Benefits

Contractors Providing Benefits

The Department of State Health Services (DSHS) works with contractors to provide newborn screening benefits and services to eligible clients in Texas using Newborn Screening Program (NBS) Benefits. To provide these approved services and benefits, contractors are required to understand and be knowledgeable of terminology, eligibility screening requirements and processes as well as comply with specific federal and state laws and procedures.

The NBS Benefits Contractor Procedures Manual and Supplement Benefits Lists provide important information to contractors. NBS Benefits provides reimbursement to enrolled providers for the provision of specified services to eligible clients in accordance with the NBS Program rules. The manual describes the qualifications for benefit service providers, the client eligibility process, and billing and reimbursement. The supplements to the manual are separately posted to allow for ease of updating as needed.

Call Irma Hernandez at 512-776-2983 if you have any questions.

2016 Contractor Manual

Eligibility Forms and Instructions

Monthly Billing and Report Forms and Instructions

Optional Forms

Eligibility Requirements

Infants, children, and adults are prioritized by need as funds are available and meet the following:

  • Have income at or below 350% of Federal Poverty Income Level
  • Are diagnosed with disorder identified by Newborn Screening Program
  • Are a bona fide resident of the State of Texas
  • Have an annual renewal review
  • Are ineligible for other programs providing the same services such as:
    • Medicaid recipients
    • Children with Special Health Care Needs (eligible if on waiting list)
    • Children’s Health Insurance (CHIP) program
    • CHIP Perinatal
    • Title V Genetic Services
    • Private Insurance

Benefits Provided

  • Dietary supplements (metabolic foods, low-protein foods)
  • Medications
  • Vitamins
  • Confirmatory testing, evaluation, and follow-up care
  • Reimbursement to specialists for telephone consults

Eligibility is determined by NBS Benefits. Call 1-800-252-8023 ext. 2983 for questions.

Eligible Providers  

  • Medical geneticists and clinics
  • Centers specializing in metabolic, endocrine and hematological disorders
  • Laboratories that provide confirmatory testing
  • Pharmacies that provide vitamins, medications, dietary supplements (metabolic foods)
  • Low-protein food manufacturers

Newborn screening disorders

Open enrollment information

Please email Kimberly Tolbert if you have questions about open enrollment. 

Last updated March 31, 2016