The Family Planning Program (FPP) helps fund clinic sites across the state to provide high-quality, comprehensive, low-cost and accessible family planning and reproductive health care services to Texans. These services help people plan the number and spacing of their children, reduce unintended pregnancies, improve future pregnancy and birth outcomes, and improve general health.
Note: State law prohibits the use of FPP funds to perform or promote elective abortions. The FPP cannot contract with entities that perform or promote elective abortions or affiliate with entities that perform or promote elective abortions
Grantees that provide HHSC FPP services can find information regarding policies, billing forms and more at:
Grantees can get voucher documents from their program contract manager.
Frequently Asked Questions (FAQ) for HHSC FPP
Who can provide FPP services?
Providers must meet certain criteria to provide services, including:
- The ability to deliver the types of services available through the program.
- Complete the Medicaid enrollment process and receive approval through the Texas Medicaid & Healthcare Partnership.
- Can certify that they don’t perform or promote elective abortions or affiliate with an entity that performs or promotes elective abortions, in accordance with the FPP rules located in the Texas Administrative Code (TAC) Title 1, Part 15, Chapter 382, Subchapter B, §§382.115.
What services are covered in FPP?
- Contraceptive services
- Barrier devices (e.g., condoms, spermicides)
- Hormonal contraceptives (e.g., oral contraceptives, injectable contraceptives)
- Long-acting reversible contraceptives (PDF)
- Counseling and education on sexual abstinence
- Pregnancy testing and counseling
- Preconception health screenings (e.g., screening for obesity, hypertension, diabetes, cholesterol, smoking and mental health)
- Sexually transmitted infection services
- Sterilization (e.g., tubal ligation, hysteroscopic occlusion, vasectomy)
- Screening for postpartum depression
- Clinical breast exams
- Breast and cervical cancer screening and diagnostic services
- Radiological procedures, including mammograms
- Screening and diagnosis of breast cancer
- Diagnosis and treatment of cervical dysplasia
What is long-acting reversible contraception?
Long-acting reversible contraception (LARC) is a highly effective contraceptive option with high rates of patient satisfaction and method continuation. Some examples of long-acting reversible contraception include an intrauterine device (IUD) and a birth control implant. Learn more about LARCs and implementing the Texas Medicaid policy on providing LARC services through the Texas LARC Toolkit (PDF).
What is postpartum depression?
Postpartum depression (PPD) is a common, potentially serious and sometimes life-threatening condition. Although the term PPD is commonly used, it’s important to note that depression can occur during pregnancy as well as after the baby is born.
To learn more about implementing the Texas Medicaid policy on providing PPD services, read the Texas Clinician’s Postpartum Depression Toolkit (PDF).
How does a client get contraception through FPP?
Contraception, except emergency contraception, is provided through a family planning clinic or by prescription at an on-site or local pharmacy.
What is preconception health and counseling?
Preconception health is the state of a woman's health before she becomes pregnant. It focuses on conditions and risk factors that could affect a woman, her unborn baby, or both. Preconception health care seeks to identify clients with risk factors (such as overweight and obesity, diabetes, low folic acid intake, and smoking or alcohol use) that must be acted on before conception to prevent fertility problems and reduce health problems of the mother and baby. By acting on health issues and risks before pregnancy, a woman can prevent problems that might affect her or her baby.
Preconception health care is a critical component of health care for women of a reproductive age. The main goal of preconception health care is to provide health promotion, counseling, screenings and interventions to reduce risk factors that might affect future pregnancies.
Can providers charge co-payments to clients covered by FPP?
All FPP services provided at an HHSC FPP-funded clinic, including non-reimbursable services, must be offered with a sliding scale fee. However, no client shall be denied services based on an inability to pay. Read the Family Planning Program Policy Manual for more information regarding co-pays and the suggested co-pay table (PDF).
How do I make referrals to other providers and programs?
If a client covered by the FPP doesn’t want to pay out-of-pocket for services not covered by the program, providers must refer them to another physician or clinic. Providers should make referrals when health issues are identified and necessary services related to those health issues are not covered under the program.
Individuals in need of treatment for postpartum depression must be referred to a provider of behavioral health services. Providers must have arrangements in place before referring individuals to behavioral health providers in their area.
HHSC prefers referrals to local indigent care services, but 2-1-1 Texas can assist with locating other primary care providers, if needed.
The HHSC Breast and Cervical Cancer Services (BCCS) program offers free breast and cervical cancer screening and diagnostic services to eligible women. Additionally, the program provides Medicaid coverage to eligible women diagnosed with breast or cervical cancer and cervical dysplasia management, and treatment for BCCS-enrolled women.
What happens if a patient is diagnosed with breast or cervical cancer?
FPP providers should refer clients who need a cancer screening to a BCCS contractor. If a client is diagnosed with breast or cervical cancer, she may be eligible for Medicaid for Breast and Cervical Cancer (MBCC). MBCC provides access to cancer treatment services through full Medicaid benefits to qualified women. If a client needs treatment, she must be referred to a BCCS contractor to determine eligibility. BCCS contractors will assist referred clients through the application process, make a predetermination on eligibility, and help navigate the client through additional resources if needed. Find a BCCS provider through the Healthy Texas Women (HTW) clinic locator.
Who is eligible for FPP?
Note: Services may be provided to individuals with third-party insurance if the confidentiality of the person is a concern or if the person's insurance deductible is 5% or more of their monthly income.
Do all applicants have to prove income eligibility?
No. If an applicant or family member can prove through an initial or renewal eligibility screening that they participate in any of the below services, they are considered to also be eligible for the HHSC Family Planning Program:
- Children's Health Insurance Program (CHIP)
- Supplemental Nutrition Assistance Program (SNAP)
- Temporary Assistance for Needy Families (TANF)
- Special Supplemental Nutrition Program for Women, Infants and Children (WIC)
If an applicant doesn’t participate in any of the above services, they will be asked to prove income eligibility.
Note: If the methods used for income verification jeopardize the individual's right to confidentiality or impose a barrier to receive services, the contractor must waive this requirement and approve full eligibility. Reasons for waiving verification of income must be noted in the individual's record.
Are individuals who have been sterilized eligible?
Can pregnant women enroll?
Pregnant women can be enrolled in both the FPP and CHIP Perinatal programs. While pregnant women may be served in the FPP, there are only limited prenatal services available for coverage. As a result, providers should make every effort to assist pregnant women to receive more comprehensive prenatal and perinatal care, including enrollment and referral to Medicaid for Pregnant Women and CHIP Perinatal, and the Title V Maternal Child Health Fee-For-Service Program.
If a woman becomes pregnant while she is covered by the FPP, contractors may bill the FPP for allowable services provided in clinical prenatal care visits for women during the Medicaid for Pregnant Women and CHIP Perinatal enrollment processes.
When is parental consent needed?
If a client is 17 or younger, they must have a parent or legal guardian apply, renew and report changes on their behalf to receive FPP services.
All program services must be provided with consent from the minor's parent, managing conservator or guardian as authorized by Texas Family Code, Chapter 32, or by federal law or regulations.
To learn more about health and health-related legal issues that apply to minors, see the Responsibilities for Treatment of Minors within the Family Planning Program and HTW Program (PDF).
How do individuals apply for the program?
If an individual is found ineligible for Medicaid and HTW, they can apply to the FPP.
Determining eligibility can be completed over the phone or in the office. The completed eligibility form must be kept in the individual's record and must show their poverty level and the co-pay amount they may be charged.
If eligibility is determined over the phone, the contractor is authorized to sign the form on the applicant's behalf using a digital ID or handwritten signature.
What name should be used on the application?
The name printed on the applicant's Social Security card or government-issued identification.
How long does it take for applications to be processed?
HHSC FPP contracted providers must screen all family planning applicants for eligibility in the following programs that provide family planning services, in this order:
- HHSC FPP
Once a client is deemed ineligible for Medicaid and HTW, the clinic will determine whether a client is eligible for the FPP.
It can take up to 45 days for Medicaid or HTW applications to be processed. If questions arise, clients should contact 866-993-9972 to discuss the status of their application.
An individual is eligible for services beginning at the date the contractor determines the individual is eligible for the program and signs the completed application. Services delivered while a client's application was pending may be billed to the FPP for up to 95 days prior to determining eligibility.
How often does a client need to reapply for the program?
Clients must reapply annually.
What if a client needs to report a change to their information?
The client must let the clinic know if there are changes to their information.
When does coverage start?
Coverage can start once a client is deemed eligible for the program.
Does enrollment in the FPP affect other HHSC benefits?
Who can we call or email for help?
Potential clients can search for a FPP clinic here: Family Planning Program | Healthy Texas Women. The clinic will determine whether a client is eligible.
For provider questions regarding billing or claims, call the Texas Medicaid & Healthcare Partnership contact center at 800-925-9126 and select Option 5.
For client questions or to find a provider call 800-335-8957, select a language, then select Option 5. For potential and current client questions related to the HHSC FPP, email the Family Planning Program.
For provider questions related to HHSC FPP billing or claims, email Healthy Texas Women.
For questions related to your HHSC FPP contract, email PSPS Contracts.
For questions related to HHSC FPP policy and clinical guidelines, email the Family Planning Program.
Family Planning Program
North Austin Complex, MC 0224
4601 W. Guadalupe St., Suite #4.507
Austin, TX 78751
Provider questions: 800-925-9126 (TMHP contact center; pick Option 5)