Blue Review
A Medicaid Provider Newsletter

February 2018

Texas Health Steps (THSteps) Medical Requirements and References

As a reminder, medical checkup requirements have two different components: federal mandates and state requirements.

Federal Mandates
The federally mandated components include, but are not limited to the following:

  • Comprehensive Health and Developmental History:
    • Tuberculosis screening
    • Physical, mental and developmental histories
    • Autism screening
    • Nutrition screening
  • Comprehensive Unclothed Physical Examination:
  • Immunizations: Age appropriate by periodicity schedule
  • Laboratory Screenings:
    • Newborn
    • Blood-lead level (12 and 24 months)
    • Anemia (H/H at 12 months)
    • Risk-based tests (lipids 9 - 11 years old and 18 - 20 years old)
    • HIV testing for 16 - 18 years old
    • Type 2 diabetes and STD/STI as needed per risk assessment
  • Health Education/Anticipatory Guidance: These are age appropriate. To provide the best care and assure compliance, you can use the provided age appropriate forms from the THSteps website.

State Requirements
The state requirements include the following:

  • Dental referral every six months until a dental home is established
  • Follow-up instructions for your patient’s next preventive visit

Additionally, each page of the patient’s record needs to include the patient’s name and identifiers with each entry signed by the provider, with credentials and date.

THSteps Quick Reference Guide
We know that you and your staff strive for accuracy, so we have provided the link to the Texas Medicaid and Healthcare Partnership THSteps Quick Reference Guide that summarizes the process for billing and procedure codes.

Additional Resources