The Texas Health Steps Medical Checkup Periodicity Schedule for infants, children, and adolescents (birth through 20 years of age) has been revised to reflect policy changes effective June 1, 2021. Download the LARGE version in Color (PDF) or Pocket-Sized (MINI) in Color (PDF), or place an order for the laminated Periodicity Schedule from the Texas Health Steps Resource Catalog.
Anticipatory Guidance: A Guide for Providers
This guide was designed specifically for THSteps providers (PDF). It offers age-appropriate anticipatory guidance topics for children, birth through 20 years of age, and mirrors anticipatory guidance topics included on the THSteps Child Health Clinical Record Forms.
Adolescent Health: A Guide for Providers
This guide was designed for healthcare providers and other professionals who provide services, information, and support to young people (PDF). It offers guidelines on health and health-related legal issues pertinent to the adolescent years.
These tools were designed by THSteps to assist medical providers in incorporating other members of the team in completing THSteps Checkups. Other team members include front office staff and clinical staff.
- THSteps Checkup Whole Office Approach (Excel)
- Checkup Components Whole Office Approach (PDF)
- OEFV Whole Office Approach (PDF)
Checkup Documentation Improvement
All Texas Health Steps medical and dental checkups and other services require documentation within the client's medical record to support the service provided. Medical and dental services, including Texas Health Steps checkups, are subject to retrospective review and recoupment if documentation within the client's medical record does not support the service submitted for payment. State–contracted medical record reviews have shown that client medical records for Texas Health Steps services often have incomplete or missing documentation, making them subject to recoupment.
The following resources will assist you in completing Texas Health Steps checkup documentation:
- The Texas Health Steps Documentation Improvement Provider Letter (PDF) describes the importance of documenting each component and sub-component of a Texas Health Steps Checkup.
- Texas Health Steps Clinical Record Review Tool with Instructions (Excel) assists in self-audits in preparation for health plan quality reviews. This electronic format will self-populate totals with numerical values.
- Texas Health Steps Clinical Record Review Tool (PDF) provides a printable paper copy of the clinical record review tool. Instructions for paper copy use are included in the Excel workbook.
Contact your Texas Health Steps regional provider relations representative (PDF) for help and support with documenting Texas Health Steps checkups.
Texas Health Steps Preventive Care Medical Checkups, Mental Health Screenings in Adolescents, Changes Effective July 1, 2018
Effective July 1, 2018, mental health screenings may be completed annually for all adolescents 12 through 18 years of age. Separate reimbursement will be available to providers annually when mental health screening is completed annually using one or more of the validated, standardized mental health screening tools approved by Texas Health Steps.
Texas Health Steps has added two additional screening tools for mental health screenings in adolescents. Approved screening tools now include:
- Pediatric Symptom Checklist (PSC-17)
- Pediatric Symptom Checklist (PSC-35)
- Pediatric Symptom Checklist for Youth (Y-PSC)
- Patient Health Questionnaire (PHQ-9)
- Patient Health Questionnaire Modified for Adolescents (PHQ-A [depression screen])
- Car, Relax, Alone, Forget, Family, and Trouble Checklist (CRAFFT)
- Patient Health Questionnaire (PHQ-A [anxiety, eating problems, mood problems and substance abuse])
Texas Health Steps Preventive Care Medical Checkups, Mental Health Screenings in Infants, Changes Effective July 1, 2018
Effective July 1, 2018, maternal postpartum depression screening may be completed and reimbursed once per provider, in the 12 months following the infant's birth during a Texas Health Steps checkup when the screening is completed using a validated screening tool.
Validated screening tools include the following:
- Edinburgh Postnatal Depression Scale (EPDS)
- Postpartum Depression Screening Scale (PPDS)
- Patient Health Questionnaire (PHQ-9)
- Lab Supply Order Information
- THSteps Medical Checkup Laboratory Requirements (PDF)
- DSHS Laboratory Checklist for THSteps Medical Providers (PDF)
- Texas Health Steps Risk Based Guidance Tool (PDF)
- DSHS Laboratory Home Page
- The DSHS Remote Data System allows providers to access results and in some cases, enter and submit patient data electronically. Results are available for the following:
THSteps Preventive Care Medical Checkup Requirement for Elevated Blood Levels - In accordance with Texas Administrative Code (TAC), Title 25 (Part 1), Chapter 37, Subchapter Q Rule §37.334, the elevated blood lead level requirement has been reduced from 10 mcg/dL to 5 mcg/dL. For an elevated blood lead level of 5 mcg/dL or greater, the provider must perform a confirmatory test using a venous specimen. The confirmatory specimen may be sent to the DSHS Laboratory, or the client or specimen may be sent to a laboratory of the provider's choice.
Information related to blood lead screening and reporting for clients who are 15 years of age and older is available on the DSHS Blood Lead Surveillance Group's website.
Reporting Blood Lead Results Electronically
Healthcare Providers have the option to submit blood lead reports electronically using a secure FTP server. Visit Texas Childhood Lead Poisoning Prevention Program for electronic reporting.