Texas Health Steps Frequently Asked Questions

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What forms are we required to use for a THSteps exam?

The Denver Developmental Screen is very time-consuming.  Are there easier/more practical assessments that can be used?

Can we limit the number of THSteps clients we accept or do we have to accept all who call?

What can be done about clients who continue to be no-shows, even after missed appointment referrals?  What about disruptive behavior?

What do I do if a parent refuses to have a potion of the exam preformed on the child?

How do I bill for immunizations given "outside" of an THSteps exam?

How do I bill for services that occur with a THSteps exam but are acute, not preventative, services?

What forms are we required to use for a THSteps exam?
The tuberculosis screening form and the lead risk assessment forms. Both of these are in the Medicaid Service Delivery Guide, Appendix G, in both English and Spanish.

The Denver Developmental Screen is very time-consuming. Are there easier/more practical assessments that can be used?
The Medicaid Service Delivery Guide, page 13 states that physicians can, but are not required, to perform formal developmental screenings.  A non-physician conducting THSteps checkups on children ages 0-6 are required to do a standardized observational developmental screen per child once between the ages of 9-12 months and between ages 18-24 months.  If, in screening a child 24 months to 6 years, the screener has no record of a standardized observational developmental screen done on the child, the screener should perform the screen (and also may perform the screen at other ages, at the screener’s discretion).

On page 14 the guide states, “A standardized tool is one that has been extensively evaluated through screening thousands of children and comparing the screen outcome of each individual child with the outcome of an in-depth developmental evaluation on that child.  If the screening tool specifies that training is required to use the tool, the screener must complete this training."

Can we limit the number of THSteps clients we accept or do we have to accept all who call?
Providers may determine the number of THSteps clients their practice can serve but discriminatory factors cannot be used to selectively exclude or include specific clients.

What can be done about clients who continue to be no-shows, even after missed appointment referrals? What about disruptive behavior?
Offices can enforce policies which involve refusal of services to clients who no-show a specific number of appointments or who engage in disruptive behavior.  The policy must apply to both Medicaid and private-pay patients and so state.

What do I do if a parent refuses to have a portion of the exam performed on a child?
Record the incident in the patient record.  It is also recommended that the reason for the refusal be explored with the parent and this also be recorded.

How do I bill for immunizations given “outside” of a THSteps exam?
Immunizations not in conjunction with a THSteps exam or follow-up are as a Medicaid service, not a THSteps service.  Use Medicaid coding.

How do I bill for services that occur with a THSteps exam but are acute, not preventive, services?
Conditions that are discovered during an exam, which require treatment, are billed as a Medicaid, rather than THSteps, service.

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Last updated April 13, 2011