Newborn Screening Benefits Program

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Contract Agencies Providing Benefits

This page provides information to agencies that contract with the Texas Department of State Health Services to provide newborn screening benefits to eligible clients.

Below are the Provider Manual and a Summary of Changes.  Very few changes were made to the medication, vitamins and dietary supplements at this time.  Other revision may follow as needed.  Call Cathy LaCrosse at 512-776-2983 if you have any questions.

2012 Contractor Mannual

Eligibility Forms and Instructions

Monthly Billing and Report Forms and Instructions

Optional Forms

Eligibility requirements 

Infants, Children & Adults; prioritized by need as funds are available:
  • Income at or below 350% of Federal Poverty Income Level
  • Diagnosed with disorder identified by Newborn Screening Program
  • Bona fide resident of the State of Texas
  • Annual recertification review
  • Ineligibility for other programs providing the same services:
    • Medicaid recipients
    • Children with Special Health Care Needs (eligible if on waiting list)
    • Children’s Health Insurance program
    • CHIP Perinatal
    • Title V Genetic Services
    • Private Insurance

Provides

  • Dietary Supplements (metabolic foods, low-protein foods)
  • Medications
  • Vitamins
  • Confirmatory testing, evaluation, and follow up care
  • Reimbursement to specialists for telephone consults

Eligibility is determined by NBS Benefits 1-800-252-8023 ext. 2983

Eligible Providers

  • Medical Genetic Clinics
  • Centers specializing in Metabolic, Endocrine and Hematological Disorders
  • Medical Geneticists
  • Laboratories that provide confirmatory testing
  • Pharmacies that provide vitamins, medications, dietary supplements (metabolic foods)
  • Low-protein food manufacturers

           
Benefits

Presumptive Positive:
            Infant eligible for two months of formula immediately upon positive results, if eligible   
            Confirmatory testing

Confirmed Diagnosis: 
            Evaluation & Management
            Follow-up care, including laboratory testing
            Remediation services-prescribed dietary supplements, vitamins, &/or  
            medications, low-protein foods

Newborn Screening Disorders

NBS Benefits Q&A (under revision)

Open Enrollment Information

Please email questions to Bill Walk

 

 

Last updated June 26, 2013