Texas Health Steps

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. EPSDT was created by the 1967 amendments to the federal Social Security Act and defined by the Omnibus Budget Reconciliation Act of 1989. In Texas, EPSDT is known as Texas Health Steps, which includes the preventive care components, or Early and Periodic Screening, of the total EPSDT service. In addition, medically necessary health-care services listed in the Act are provided to children and adolescents enrolled in Texas Health Steps even if the service is not available under the state's Medicaid plan to the rest of the Medicaid population. These additional services, particular to Texas Health Steps, are available through the Comprehensive Care Program.

The Texas Medical Assistance (Medicaid) Program was implemented September 1, 1967, under the provisions of Title XIX of the Federal Social Security Act and Chapter 32 of the Texas Human Resources Code. The cost of Medicaid is shared by the State of Texas and the federal government. The Texas Health and Human Services Commission, the single state Medicaid agency, is responsible for the Title XIX Program. The administration of the program is accomplished through contracts and agreements with medical providers, claims administrators (claims reimbursement processor), enrollment brokers, various managed care organizations, and state agencies including the Department of State Health Services. Medicaid providers, including those providing Texas Health Steps services, are reimbursed for their services through contracts with health-insuring contractors, fiscal agents, or direct vendor payments.


Texas Health Steps (THSteps) focuses on medical, dental and case management services for people 20 and younger, and is dedicated to:

  • Expanding recipient awareness of existing medical, dental and case management services through outreach and informational efforts.
  • Recruiting and retaining a qualified provider pool to assure the availability of comprehensive preventive medical, dental, and case management services.

HHSC administers THSteps under funding from Title XIX of the Social Security Act for early and periodic screening, diagnosis and treatment services for people ages 20 and younger who have Medicaid. All Health Service Regional offices have provider relations staff (PDF) to help operate THSteps statewide.

THSteps operates under provisions in the Social Security Act, § 1905, and the Consent Decree requirements resulting from Frew, et al. v. Smith, et al. THSteps is authorized under the regulations of the:

Several additional legislative requirements affect THSteps and the participating providers. These include but are not limited to:

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.


The following provider types may provide Texas Health Steps preventive services within his or her individual scope of practice:

  • Pediatric and general dentists (DDS or DMD)
  • 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.

Contact Us

Phone: 512-438-2366
Email: thsteps@hhsc.state.tx.us