The Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) service is Medicaid's comprehensive preventive child health service (medical, dental, and case management ) for individuals from birth through 20 years of age. In Texas EPSDT is known as Texas Health Steps. EPSDT was defined by federal law as part of the Omnibus Budget Reconciliation Act (OBRA) of 1989 legislation and includes periodic screening, vision, hearing, and dental preventive and treatment services. In addition, Section 1905(r)(5) of the Social Security Act requires that any medically necessary health care service listed in the Act be provided to Texas Health Steps recipients even if the service is not available under the State's Medicaid plan to the rest of the Medicaid population. These additional services are available through the Comprehensive Care Program (CCP).
Texas Health Steps focuses on the medical, dental, and case management services for ages birth through 20, and is dedicated to:
- Expanding recipient awareness of existing medical, dental, and case management services through outreach and informing efforts, and;
- Recruiting and retaining a qualified provider pool to assure the availability of comprehensive preventive medical, dental, and case management services.
Recruiting and Retaining a Qualified Provider Pool
Medical, dental, and case management and other providers are the cornerstone to making sure that young people in Texas receive Texas Health Steps services at an early age and on a regular basis. Texas Health Steps is committed to recruiting and retaining qualified providers to assure that comprehensive preventive health, dental, and case management services are available. Providers performing medical, dental, and case management services who wish to be eligible for reimbursement for providing Medicaid and Texas Health Steps services must enroll in these programs through the Texas Medicaid and Healthcare Partnership (TMHP).
Texas Health Steps gives medical and dental checkups and care and case management services to children from birth through age 20 who have Medicaid. Texas Health Steps will:
- Help you find a doctor or dentist for your child
- Help you set up an appointment for your child to see a doctor or dentist
- Help you get a ride to a medical or dental appointment
- Answer questions you may have about the services your child can get
Call to find out more about what your child can get from Texas Health Steps
Call toll-free, 1-877-847-8377 (1-877-THSTEPS), Monday to Friday from 8 a.m. to 8 p.m., Central Time. Relay Texas
The following provider types may provide Texas Health Steps preventive services within his or her individual scope of practice:
- Physician or physician group (MD or DO)
- Physician assistant (PA)
- Clinical nurse specialist (CNS)
- Nurse practitioner (NP)
- Certified nurse midwife (CNM)
- Federally Qualified Health Center (FQHC)
- Rural Health Clinic (RHC)
- Health-care provider or facility with physician supervision including but not limited to a:
- Community-based hospital and clinic
- Family planning clinic
- Home health agency
- Local or regional health department
- Maternity clinic
- Migrant health center
- School-based health center
In the case of a clinic, a physician is not required to be present at all times during the hours of operation unless otherwise required by federal regulations. A physician must assume responsibility for the clinic's operation.