An official State of Texas website.
Case Management for Children and Pregnant Women offers help in every county in Texas.
Become a Provider
- Learn about becoming a provider (PDF)
- CPW Services: Provider Enrollment in Texas Medicaid with TMHP (PDF)
Case Management and Pregnant Women Services and Transition to Managed Care
- What a CPW Provider needs to know about the CPW Carve-In (PDF)
- Client Flyer (English) with CPW transition information (PDF)
- Client Flyer (Spanish) with CPW transition information (PDF)
Contact Program Staff
Health and Human Services Commission
Case Management for Children and Pregnant Women
Mail Code H310
P.O. Box 149030, Austin, Texas 78714-9030
701 W. 51st St., Austin, Texas 78751-3199
Email Case Management
Relay Texas Dial 7-1-1
Download the Case Management Providers by Region list (PDF).
Forms
Specific documentation for the comprehensive visit and follow-up visits, the billable components of case management, are required. All forms below are in MS Word format, unless otherwise noted, and may be completed electronically or printed. All case management activities must be documented and maintained in a client record. Providers must ensure that documentation for case management activities complies with the requirements of Case Management for Children and Pregnant Women Rule, Medicaid Policy, HIPAA and all other applicable state and federal rules and regulations.
Case Management
- CM-01A, Referral and Intake (PDF)
- CM-02, Family Needs Assessment (PDF)
- CM-02A, Migrant Information Form (PDF)
- CM-03E-S, Service Plan (PDF, English/Spanish)
- CM-03ConE-S, Service Plan Consent (PDF, English/Spanish)
- CM-04, Follow-Up Form (PDF)
- CM-04A, Follow-Up Documentation (PDF)
- CM-05, Progress Notes (PDF)
- CM-07E-S, Referral Form (PDF, English/Spanish)
- CM-08E-S, Case Closure Form (PDF, English/Spanish)
- CM-09E-S, Case Transfer (PDF, English/Spanish)
- CM-10, Notification of Significant Provider Changes (PDF)
- CM-11, Record of Billed Services [Optional] (PDF)
- CM-12, Authorization to Disclose Protected Health Information (PDF in English)
- CM-12S, Authorization to Disclose Protected Health Information (PDF in Spanish)
Quality Assurance
- CM-15, Provider Systems Review (PDF)
- CM-16, Record Review Tool for Providers (PDF)
- CM-18, QMS Client Referral Log (Excel)
- HIPAA Example (PDF)
Marketing Materials
Providers may order brochures and other marketing materials on the THSteps Catalog.
Make a Referral to Case Management
- Call 877-THSteps (877-847-8377).
- Contact the person’s Medicaid Health Plan (MCO).
- Contact a case manager (PDF) for persons enrolled in fee-for-service.
- Complete a referral form (PDF) and fax to Texas Health Steps. The fax number is 512-533-3867.
Rules and Policies
Providers must comply with the Case Management for Children and Pregnant Women, Medicaid policies, and state rules and regulations:
- Case Management for Children and Pregnant Women Rules - Texas Administrative Code (TAC), Title 25, Part 1, Chapter 27
- Texas Medicaid Provider Procedures Manual
- Health Insurance Portability and Accountability Act of 1996
- Requirements for Reporting Abuse or Neglect, as outlined in Chapter 261 of the Texas Family Code
- Texas State Board of Social Workers Examiners Rules- Regulations, Texas Administrative Code (TAC) Title 22, Part 34, Chapter 781
- Texas Board of Nursing Rules and Regulations, Texas Administrative Code (TAC), Title 22, Part 11, Chapters 211 – 227
Submit a Prior Authorization
Before April 14, 2023
HHSC will accept the following requests, for clients enrolled in fee-for-service through the authorization request website. Note: This system is for use by approved Case Management for Children and Pregnant Women providers only.
- CM-01 (Initial Prior Authorization Request)
- CM-06 (Request for Additional Visits)
- CM-06A (Request to Change Authorization to Another Case Manager)
If you have any questions, please email askcm@hhs.texas.gov.
Due to the prior authorization transition process, no prior authorizations will be accepted from April 14, 2023, through April 16, 2023.
Beginning April 17, 2023
Texas Medicaid & Healthcare Partnership (TMHP) will accept the following requests, for clients enrolled in fee-for-service through the PA on the Portal. Go to TMHP and select “Prior Authorization” from the Topics drop-down menu. To submit by fax, send to 512-514-4212.
- F00186 (Initial Prior Authorization Request)
- F00187 (Prior Authorization Request for Additional Visits)
If you have any questions, please contact the TMHP call center at 800-925-9126.
Free Continuing Education Units/Credits
The Texas Health Steps Online Provider Education Course Catalog offers FREE CE Courses to enhance your ability to provide preventive health, mental health, oral health and case management services to Medicaid eligible children in Texas.