December 2016

Texas Health Steps: The Importance of Developmental Surveillance and Mental Health Assessments

In November, we emphasized the importance of immunizations. Developmental surveillance and mental health assessments are other components that complete a Texas Health Steps (THSteps) exam. According to the Texas Health and Human Services Commission (HHSC), developmental surveillance or screenings must be performed at each checkup for patients’ birth through 6 years of age. Developmental and autism screenings must be performed according to the periodicity schedule.

THSteps recommends providers use one of the following validated and standardized tools when performing developmental screening:

• Ages and Stages Questionnaire (ASQ)
• Ages and Stages Questionnaire: Social Emotional (ASQ:SE) or the Parents' Evaluation of Developmental Status (PEDS)
• Modified Checklist for Autism in Toddlers (M-CHAT™ or M-CHAT-R/F™) for autism screening at 18 months of age and again at 24 months of age

Note: Providers may receive separate reimbursement, in addition to reimbursement for the checkup, when using these tools as part of the checkup at the specified ages. For more information, please contact a BCBSTX Network Representative.

Developmental surveillance is required at all other checkups, and includes a review of milestones and mental health, including:

• gross and fine motor skills,
• communication skills,
• speech-language development,
• self-help/care skills and
• social, emotional and cognitive development.

Mental health screening is required at each THSteps checkup and includes behavioral, social and emotional development. Mental health screening using one of the following validated, standardized mental health screening tools recognized by THSteps is required once for all patients who are 12 through 18 years of age. Bright Futures offers these tools and resources on it’s website:

• Pediatric Symptom Checklist (PSC-35)
• Pediatric Symptom Checklist for Youth (Y-PSC)
• Patient Health Questionnaire (PHQ-9)
• Car, Relax, Alone, Forget, Family and Trouble Checklist (CRAFFT)

Developmental surveillance and mental health screenings are as important as the physical health components in the THSteps exam. Documenting your assessments will ensure our shared members have year-over-year developmental screenings and will show the great care you provide. Remember to check the periodicity schedule for appropriate screening ages.

Reference: Immunizations (June 27, 2016), Texas Health Steps Checkup Components