Registered nurses who do not have a CNS, NP, or CNM certification may provide Texas Health Steps medical checkups only under direct physician supervision. This means that the physician must be either on site during the checkup or immediately available to furnish assistance and direction to the RN during the checkup.
Before a physician can delegate a Texas Health Steps checkup to an RN, the physician must establish the RN's competency to perform the service as required by the physician's scope of practice. The delegating physician is responsible for supervising the RN who performs the service, and remains responsible for any service provided to a client.
To establish competency, the RN must complete required online education courses prior to providing checkup services. The RN or RN's employer must maintain documentation that the required modules were completed.
Online Provider Education Enrollment
Texas Health Steps Online Provider Education training modules are available online. To find the RN courses, click on COURSES. Then in the Course Finder, go to the drop-down menu under Topic, select Required Courses for Texas Health Steps Nurses, then click FIND>. The RN courses will be listed below. Just click on the course of your choice to enroll. You will be prompted to sign in to your account, or to register for a new account, then you will be taken to the course module.
Texas Health Steps courses are reviewed regularly for content and re-accreditation. Courses may become unavailable while being updated. RNs in the process of completing required training while these modules are unavailable are encouraged to complete them once they become available again.
Online modules are updated regularly to include new content. RNs who have already completed the required modules are encouraged, but not required, to retake the updated versions. All Texas Health Steps modules are approved for continuing education units for RNs as well as other medical disciplines.
Documenting Your Training
Texas Health Steps developed the optional Verification of Registered Nurse (RN) Competency to Perform Texas Health Steps Checkups form (PDF) for documentation of required training. RNs using the optional form should indicate any modules that were unavailable at the time of their training.
A record of completed and in progress courses can also be found on the Texas Health Steps Online Provider Education website under MY COURSES.
- Texas Board of Nursing
- Texas Board of Nursing, Nursing Practice Act
- Texas Medicaid Provider Procedures Manual, Children's Services Handbook, Section 22.214.171.124 Requirements for Registered Nurses Who Provide Medical Checkups
- Texas Health Steps encourages RNs to regularly check this website for important information, and to sign up for email updates at HHS GovDelivery.