Policy Changes

February 1, 2017 - The Pediatric Symptom Checklist-17 (PSC-17) may be used during a Texas Health Steps checkup, when performing the required mental health screening for clients who are 12 through 18 years of age. As a reminder, mental health screening for behavioral, social, and emotional development is required at each THSteps checkup. Mental health screening using one of the following validated, standardized mental health screening tools recognized by THSteps is required once per lifetime for all clients who are 12 through 18 years of age:

  • Pediatric Symptom Checklist (PSC-35)
  • Pediatric Symptom Checklist-17 (PSC-17)
  • Pediatric Symptom Checklist for Youth (Y-PSC)
  • Patient Health Questionnaire (PHQ-9)
  • Car, Relax, Alone, Forget, Family, and Trouble Checklist (CRAFFT)

Visit the Bright Futures Materials & Tools webpage to download the forms.

Refer to the current Texas Medicaid Providers Procedure Manual, Children's Services Handbook, subsection 5.3.11.1.3, "Mental Health Screening," for additional information about mental health screening requirements.

January 1, 2017 - Effective for dates of service on or after Jan. 1, 2017, Texas Health Steps mental health screening procedure code 99420 will be discontinued by Centers for Medicare and Medicaid Services in accordance with the 2017 annual Healthcare Common Procedure Coding System update. Procedure code 99420 will be replaced by two new procedure codes, 96160 and 96161.

Mental health screening for behavioral, social, and emotional development is required at each THSteps checkup. Mental health screening using one of the validated, standardized mental health screening tools recognized by THSteps is required once for all clients who are 12 through 18 years of age. A mental health screening must be submitted with procedure code 96160 for a screening tool completed by the adolescent, or procedure code 96161 for a screening tool completed by the parent or caregiver on behalf of the adolescent. When claims with procedure code 96160 or 96161 are submitted for mental health screenings, one of the validated, standardized mental health screening tools recognized by THSteps must be used. Only one procedure code (96160 or 96161) may be reimbursed for the mental health screening per client per lifetime based on the description of the procedure code and the service rendered. Procedure codes 96160 and 96161 will not be reimbursed for the same client for any date of service. Procedure code 96160 or 96161 must be submitted with the same date of service by the same provider as procedure code 99384, 99385, 99394, or 99395. The client's medical record must include documentation identifying the tool that was used, the screening results, and any referrals that are made.

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

For additional information, please refer to the Texas Medicaid Provider Procedures Manual Children's Services Handbook, subsection 5.3.11.1, Comprehensive Health and Developmental History.

February 1, 2016 - Diagnosis codes Z00110 and Z00111 have been added as payable newborn diagnosis codes for procedure codes 99381, 99382, 99383, and 99384 (new client preventive visits), or 99391, 99392, 99393, and 99394 (established client preventive visit).

ICD-10-CM Codes:

  • Z00110, Routine newborn exam, birth through 7 days
  • Z00111, Routine newborn exam, 8 through 28 days
  • Z00129, Routine child exam
  • Z00121, Routine child exam, abnormal
  • Z0000, General adult exam
  • Z0001, General adult exam, abnormal

Contact Texas Health Steps Regional Provider Relations Staff.

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