Texas Health Steps Provider Information

PERIODICITY SCHEDULE - See CURRENT NOTICES section below for information on Texas Health Steps November 1, 2015 policy changes. The Texas Health Steps Medical Checkup Periodicity Schedule for infants, children, and adolescents (birth through 20 years of age) has been revised to reflect policy changes effective November 1, 2015. Place an order online for laminated hard copies, or download the LARGE version in Color [PDF 152KB] and Black & White [PDF 104KB] or Pocket-Sized (MINI) in Color [PDF 128KB] and Black & White [PDF 88KB]. (You may need to adjust print settings to select "Actual size" under "Page Sizing & Handling"). Please contact a THSteps Provider Relations Representative for additional information. PLEASE NOTE: PDF AND/OR HARD COPY VERSIONS DATED NOVEMBER 1, 2015 SHOULD BE RECYCLED AS THEY CONTAIN AN ERROR WITH DYSLIPIDEMIA SCREENING. THE CORRECT VERSION WILL SHOW A DATE OF NOVEMBER 16, 2015.  

Anticipatory Guidance-A Guide for Providers has been designed specifically for THSteps providers. It offers age-appropriate anticipatory guidance topics for children birth through 20 years of age.

ADOLESCENT HEALTH GUIDE - Designed for health-care providers and other professionals who provide services, information, and support to young people. It offers guidelines on health and health-related legal issues pertinent to the adolescent years. Adolescent Health-A Guide for Providers [PDF 500KB] Updated August 2016 


Zika in Texas - The Texas Department of State of Health Services has developed a Zika Communications Toolkit (http://www.texaszika.org/materials.htm#toolkit) for any organization interested in sharing important information about the Zika Virus with their constituents. The Toolkit includes a variety of both English and Spanish newsletter copy as well as social media copy and graphics for all Texans, pregnant women, travelers and people who work outdoors. Please feel free to use and share the copy.

Texas Health Steps Policy Change - February 1, 2016 - Benefit criteria for Texas Health Steps medical checkups has changed for dates of service on or after February 1, 2016. Diagnosis codes Z00110 and Z00111 have been added as payable newborn diagnosis codes for procedure codes 99381, 99382, 99383, and 99384 (new client preventive visits), or 99391, 99392, 99393, and 99394 (established client preventive visit).

Texas Health Steps Policy Changes-April 1, 2015 and November 1, 2015

ICD-10-CM Coding for Texas Health Steps - The International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) implemented October 1, 2015. Effective for dates of service on or after October 1, 2015, codes Z00129 and Z00121 replaced ICD-9-CM diagnosis code V202 for medical checkups, exception to periodicity checkups and follow-up visits. Effective November 1, 2015, diagnosis codes Z0000 and Z0001 were added as new codes for medical checkups, exception to periodicity checkups, and follow-up visits for clients 18 to 20 years of age. Effective February 1, 2016, diagnosis codes Z00110 and Z00111 were added as payable newborn diagnosis codes.

ICD-10-CM Code
Z00110  Routine newborn exam, birth through 7 days
Z00111 Routine newborn exam, 8 through 28 days
Z00129 Routine child exam
Z00121 Routine child exam, abnormal
Z0000 General adult exam
Z0001 General adult exam, abnormal

Additional information on ICD-10-CM changes and claims information can be found at http://www.tmhp.com/Pages/CodeUpdates/ICD-10.aspx and in the Texas Medicaid Provider Procedures Manual Children’s Services Handbook, Subsection 5.5.1, “Claims Information”.

Federal Re-enrollment - Texas Medicaid must comply with federal regulations which require all providers to revalidate their enrollment information every three to five years. In accordance with this mandate, the Centers for Medicare & Medicaid Services (CMS) require that states complete the initial re-enrollment of all providers by March 24, 2016. For Texas Medicaid, any provider enrolled before January 1, 2013, must be fully re-enrolled by March 24, 2016. Providers can begin this process immediately. In January 2016, CMS announced that the previous March 24, 2016 deadline is extended to September 25, 2016. Though this extension gives states additional time to ensure providers comply with Patient Protection and Affordable Care Act (PPACA) requirements, Texas Medicaid encourages all providers who have not yet submitted a re-enrollment application to begin this process immediately to avoid potential payment disruptions.

HHSC has developed a new web page where proposed Medicaid policy changes will be listed. The page also explains how to comment on the changes and allow people to recommend new medical and dental benefits. Click on "˜Sign up for e-mail updates" on that page to subscribe to email updates to the page.

Caries Risk Assessment Now Mandatory - As of October 1, 2015, Texas Health Steps requires caries risk assessment and documentation to be included in all dental exams. Reimbursement for dental exams on or after January 1, 2016, will be denied by Medicaid unless a caries risk assessment has properly been conducted, documented, and coded.

Click here for more information about STAR KIDS, a new Medicaid managed care program for children who receive disability-related Medicaid. (Anticipated to begin Fall 2016)


DSHS News Releases

FLU - www.texasflu.org/

Influenza Information for Health Care Professionals


Ages & Stages Questionnaires®

AAP Developmental Behavioral Pediatrics Online

Anticipatory Guidance Resource List [PDF 112KB] Text Only

Asthma-Guidelines for Diagnosis and Management

Parent Health Care Guide - Designed for families to help in determining the appropriate level of health care needed for different illnesses and or injuries. [PDF 3.42MB]

Checkup Components 

Child Health Clinical Record Forms

Contact Information-THSteps Provider Relations / Oral Health Program

Critical Congenital Heart Disease (CCHD) reporting became mandatory in Texas on September 1, 2014. Please go to the Newborn Screening website at www.dshs.texas.gov/newborn/ for complete information on CCHD screening and reporting in Texas, and to access the CCHD toolkit.

Developmental Calendar - "A Parent's Guide to Raising Healthy, Happy Children"

Developmental Screening Forms

DFPS Medical Services

Information for Health and Medical Professionals Referring To Early Childhood Intervention (ECI)


Frequently Asked Questions (FAQ)s


IMPROVE - Please note that HHSC is currently restructuring the provider feedback process and allowing providers to directly connect with specific areas that interact with clients on a daily basis. Log on to HHSC's IMPROVE web page for complete information.

Your Texas Benefits Medicaid Card and Provider Website - Information on the Medicaid ID card and Medicaid eligibility verification website.

Medical Transportation Program - HHSC    

Medical Transportation Program Tutorial (Link online at txhealthsteps.com)

Modifier 25 Frequently Asked Questions [PDF 92KB]

Parent Companion: First Five Years - Texas Education Agency, Region XIII Education Service Center, and Texas Parent to Parent (TxP2P)  unveiled a new online resource for parents of young children. The website features information for parents and caregivers of children with diagnosed or suspected disabilities from birth through 5 years of age.

Provider Enrollment

Provider Outreach Referral Service

THSteps Background and How It Works


DSHS Immunization Branch

CDC's Immunization Schedule

Information on Vaccine Shortages


HIV and Dyslipidemia Screening - For information on HIV and dyslipidemia screening specimen collection link to Clinical Chemistry Testing Services-Recent Notices, then click on Specimen Requirements for THSteps HIV and Dyslipidemia Screening (Distributed 2/18/2016).

Effective January 1, 2016, only newborn screening specimen collection kits that are thought to be defective may be returned. - Link to Newborn Screening Laboratory >> scroll down to Recent Notices: >> then click on Changes to the DSHS Return Policy for Paid Newborn Screening Specimen Collection Kits (Effective 1/01/16)

THSteps Medical Checkup Laboratory Requirements [PDF 140KB] Revised January 2016

DSHS Laboratory Checklist for THSteps Medical Providers [PDF 56KB] 

Texas Health Steps Risk Based Guidance Tool Color [PDF 304KB] B&W [PDF 304KB] Text only

Newborn Screening (NBS) Laboratory

NBS Laboratory NOTICES

Information Regarding Blood Spot Card Storage and Use

DSHS Laboratory Home Page

Clinical Chemistry Testing Services- The DSHS Clinical Chemistry Laboratory provides clinical testing services in support of screening programs. 

The DSHS Remote Data System allows providers to access results over the web, and in some cases enter and submit patient data electronically.

Results are available for the following:

  • Newborn Screening (NBS) tests
  • Clinical Chemistry tests: Blood Lead, Total Hemoglobin, Hemoglobin Electrophoresis, Glucose, Lipid Panel/Cholesterol, and RPR
  • Public Health Microbiology: TB, HIV/STD, Serology, Virology, Parasitology, Bacteriology, Rabies, etc.

For more information on DSHS Remote Data Systems, link to Frequently Asked Questions.

Lab Supply Order Information - Includes the G-THSTEPS Specimen Submission Form (Scroll to bottom of that page to find information on how to obtain the G-THSTEPS form via email or phone) 

LabGuides Tutorials - LabGuides are short tutorials designed to help providers meet the acceptance criteria for certain specimens sent to the DSHS Laboratory.


THSteps Preventive Care Medical Checkup Requirement for Elevated Blood Levels - In accordance with Texas Administrative Code (TAC) Title 25 (Part 1) Chapter 37 Subchapter Q Rule §37.334, the elevated blood lead level requirement has been reduced from 10 mcg/dL to 5 mcg/dL. For an elevated blood lead level of 5 mcg/dL or greater, the provider must perform a confirmatory test using a venous specimen. The confirmatory specimen may be sent to the Department of State Health Services (DSHS) Laboratory, or the client or specimen may be sent to a laboratory of the provider’s choice.

Information related to blood lead screening and reporting for clients who are 15 years of age and older is available on the DSHS Blood Lead Surveillance Group’s website at www.dshs.state.tx.us/lead/providers.shtm

Texas Childhood Lead Poisoning Prevention Program (TXCLPPP)


Texas Medicaid Program HHSC Internet

Texas Medicaid Provider Procedures Manual (TMPPM)-The TMPPM will be updated monthly with policy and procedure changes that were implemented at the beginning of the previous month. The updated chapters will be published around the 15th of each month. The manual is available on the TMHP website on the Texas Medicaid Provider Procedures Manual Website Page and can be accessed by clicking the Reference Material button on any web page in the Texas Medicaid provider section.

TMHP Texas Health Steps Page (The THSteps Quick Reference Guide and other helpful information can be found on this TMHP internet page)

Best Practices in Delivering Medicaid Services

Medicaid and CHIP Statistics

Periodicity Schedule (Posted at top of page)

Online Provider Education (OPE)-Continuing Education (CE) Hours - Texas Health Steps' award-winning online program offers FREE CE Courses to enhance your ability to provide preventive health, mental health, oral health and case management services to Medicaid eligible children in Texas. First time users will need to register.

UNAUTHORIZED WEBSITE ADVISORY:  Please be advised that there is a separate, privately owned and operated website located at http://ww42.texashealth steps.com that is not authorized, or affiliated with, Texas Health Steps, DSHS, or any of the Texas Health and Human Services agencies, which do not approve of the website or endorse any of its contents. Contact info@txhealthsteps.com if you have questions. 

TMHP Provider Education Home Page - This is the homepage for all of the provider education opportunities offered by TMHP. Providers can run computer-based training (CBT) modules, register for workshops and webinars, listen to or read transcripts of past webinars or Radio TMHP offerings, and access written workshop materials. To view a CBT, you must be registered on the Learning Management System (LMS) server.

Vendor Drug Program-Pharmacy Continuing Education


Last updated August 24, 2016