Texas Health Steps Provider Information

Periodicity Schedule

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 July 1, 2018. Download the  LARGE version in Color (PDF) or  Pocket-Sized (MINI) in Color (PDF), or place an online order for the laminated Periodicity Schedule from the  Texas Health Steps Resource Catalog.

Please  contact a Texas Health Steps Provider Relations Representative for additional information.  

Anticipatory Guidance: A Guide for Providers

This guide, designed specifically for Texas Health Steps providers, offers age-appropriate anticipatory guidance topics for children birth through 20 years of age.

Adolescent Health: A Guide for Providers

This guide was 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. ( PDF version) (updated August 2016) 

Checkup Components

Texas Health Steps Policy Changes 


Free CME Webinar on Postpartum Depression Screening and Mental Health Screening In Adolescents

The Health and Human Services Commission’s Online Provider Education program in partnership with the Texas Medical Association will be presenting a free CME live webinar on postpartum depression screening and mental health screening in adolescents as part of a routine checkup.

The live webinar will be presented on August 23, 2018, 12:00 PM – 1:00 PM (Central time), and will provide 1 AMA PRA Category 1 Credits™(Live). Registration is free for TMA members. Nonmembers should use coupon code THSEDU to register free. Nonmember registration is limited to 200 participants.

The live webinar will be recorded and available as an enduring CME event.

Registration for the webinar is available on the TMA website. Registration is also available on the THSteps Online Provider Education website.

Texas Health Steps Preventive Care Medical Checkups, Mental Health Screenings in Adolescents, Changes Effective July 1, 2018

Mental health screening for behavioral, social, and emotional development is required at each Texas Health Steps checkup birth through 20 years.

In 2017, the 85th Texas Legislature, Regular Session, passed legislation regarding mental health screenings in adolescents. Based on requirements specified in House Bill 1600, Texas Health Steps must make changes to checkup requirements for mental health screenings in adolescents.

Effective July 1, 2018, mental health screenings may be completed annually for all adolescents 12 through 18 years of age. Separate reimbursement will be available to providers annually when mental health screening is completed annually using one or more of the validated, standardized mental health screening tools approved by Texas Health Steps.

Texas Health Steps recommends all clients who are 12 through 18 years of age receive a mental health screening annually.

Providers completing mental health screenings in adolescents must continue to use procedure code 96160 or 96161.

Texas Health Steps has added two additional screening tools for mental health screenings in adolescents. Approved screening tools now include:

  • Pediatric Symptom Checklist (PSC-17)
  • Pediatric Symptom Checklist (PSC-35)
  • Pediatric Symptom Checklist for Youth (Y-PSC)
  • Patient Health Questionnaire (PHQ-9)
  • Patient Health Questionnaire Modified for Adolescents (PHQ-A [depression screen])
  • Car, Relax, Alone, Forget, Family, and Trouble Checklist (CRAFFT)
  • Patient Health Questionnaire (PHQ-A [anxiety, eating problems, mood problems and substance abuse])

Texas Health Steps Preventive Care Medical Checkups, Mental Health Screenings in Infants, Changes Effective July 1, 2018

Mental health screening for behavioral, social, and emotional development is required at each Texas Health Steps checkup birth through 20 years.

In June 2017, the 85th Texas Legislature, Regular Session, passed legislation regarding maternal postpartum depression screenings during an infant’s Texas Health Steps checkup. Based on requirements specified in House Bill 2466, Texas Health Steps checkups will allow maternal postpartum depression screening as part of mental health screenings for infants prior to their first birthday.

Effective July 1, 2018, maternal postpartum depression screening may be completed and reimbursed once per provider, in the 12 months following the infant’s birth during a Texas Health Steps checkup when the screening is completed using a validated screening tool.

Validated screening tools include the following:

  • Edinburgh Postnatal Depression Scale (EPDS)
  • Postpartum Depression Screening Scale (PPDS)
  • Patient Health Questionnaire (PHQ-9)

Positive screenings require the provider to discuss the screening results with the mother, discuss the possibility of depression and the impact depression may have on the mother, the family, and the health of the infant, and refer the mother to a provider who can perform further evaluation and determine an appropriate course of treatment.

Providers completing maternal postpartum depression screening must use procedure code G8341 or G8350 in order to receive separate reimbursement.

Providers must document the screening in the infant’s medical record.

Additional information on changes to mental health screenings in adolescents and infants will be posted as soon as it is available.

Texas Health Steps encourages providers to routinely check this webpage and TMHP Provider Notices and Banner Messages for updates on Texas Health Steps checkup components, policy changes, and other important information.

Texas Health Steps Postpartum Depression Screening (PPD) Provider Tool

This PDF is available to providers to assist with implementation of postpartum depression screening during a Texas Health Steps checkup.

Healthy Texas Women
The Healthy Texas Women program offers women’s health and family planning at no cost to eligible women in Texas. Women covered by Medicaid for Pregnant Women are automatically enrolled in Healthy Texas Women at the end of Medicaid for Pregnant Women coverage. Available services include screening and both non-pharmacologic and pharmacologic treatment of postpartum depression. For more information, see the Healthy Texas Women Policy and Procedure Manual.

IMPORTANT UPDATE to Notice of Potential for Falsely Low Blood Lead Test Results from LeadCare® Analyzers posted May 17, 2017 (See below)- Magellan Diagnostics mailed notification letters to LeadCare and LeadCare II customers earlier in June concerning a formal process that entails many steps to be implemented by both the FDA and Magellan Diagnostics. Please link to Magellan Diagnostics to view copies of the Cover letter, Customer letter, and Fax form record. If you have questions, please contact Magellan toll-free at 1-800-275-0102 or email LeadCareSupport@magellandx.com.

Potential for Falsely Low Blood Lead Test Results from LeadCare® Analyzers - On May 17, 2017 the Centers for Disease Control (CDC) released an official Health Advisory for Magellan Diagnostics’ LeadCare Analyzers. The CDC Health Advisory states the FDA has issued a warning that Magellan Diagnostics’ LeadCare® analyzers (LeadCare, LeadCare II, LeadCare Ultra and LeadCare Plus) may underestimate blood lead levels and provide falsely low test results when testing venous blood samples. There is no evidence of the problem when testing capillary blood samples collected by fingerstick or heelstick. At this time the alert does not apply to capillary blood lead test results. THSteps providers may continue to use Magellan Diagnostics’ LeadCare II Analyzers for point-of-care blood lead screening when testing capillary blood samples. The DSHS Laboratory completes blood lead testing using graphite furnace atomic absorption spectrometry (GFAAS) to analyze all blood lead samples. The FDA warning does have any effect on results from blood lead samples that have been submitted and tested using one of the recommended high complexity analytical methods, such as GFAAS. THSteps providers may continue to submit blood lead samples to the DSHS Laboratory for blood lead analysis.  Please link to the CDC internet at https://emergency.cdc.gov/han/han00403.aspfor access to the entire CDC Health Alert and other important information.

Reporting Blood Lead Results Electronically

- Healthcare Providers now have the option to submit blood lead reports electronically using a secure FTP server. If you are interested in reporting electronically, please link to Texas Childhood Lead Poisoning Prevention Program (TXCLPPP) at /lead/child.shtm

THSteps Checkup Documentation Improvement - All Texas Health Steps medical and dental checkups and other services require documentation within the client’s medical record to support the service provided. Medical and dental services, including Texas Health Steps checkups, are subject to retrospective review and recoupment if documentation within the client’s medical record does not support the service submitted for payment. State–contracted medical record reviews have shown that client medical records for Texas Health Steps services often have incomplete or missing documentation, making them subject to recoupment.

The Texas Health Steps Documentation Improvement Provider Letter describes the importance of documenting each component and sub-component of a Texas Health Steps Checkup.

The following resources will assist you in completing Texas Health Steps checkup documentation:

Contact your Texas Health Steps regional provider relations representative for help and support with documenting Texas Health Steps checkups.


DSHS News Releases

FLU - www.texasflu.org/

Zika in Texas 


Ages & Stages Questionnaires®

AAP Developmental Behavioral Pediatrics Online

Anticipatory Guidance Resource List [PDF 112KB] Text Only

Asthma-Guidelines for Diagnosis and Management

Caries Risk Assessment 

Checkup Components 

Child Health Clinical Record Forms

Contact Information- THSteps Provider Relations Repesentatives

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

Developmental Screening Forms

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


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)

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


Lab Supply Order Information - Includes the G-THSTEPS Specimen Submission Form (Revised September 2017) - Scroll down on that page to find a link to the sample G-THSTEPS form along with information on how to obtain the form via email or phone. Links to other DSHS laboratory forms, laboratory fee schedules, and other important information required for specimen submission can also be found on that page.

THSteps Medical Checkup Laboratory Requirements [PDF 140KB]  Text Only 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.

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

Texas Childhood Lead Poisoning Prevention Program (TXCLPPP)


Texas Medicaid and CHIP

Texas Medicaid Provider Procedures Manual (TMPPM)- Updated monthly to reflect new policy and procedure changes.

TMHP (Texas Medicaid and Healthcare Partnership) - Includes the THSteps Quick Reference Guide and other helpful information about Texas Health Steps.

STAR Kids - A Texas Medicaid-managed care program that provides Medicaid benefits to children and adults 20 and younger who have disabilities.


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.

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-Training and Continuing Education for Prescribers and for Pharmacy Staff

Last updated February 26, 2019