An official State of Texas website.
Revision 23-4; Effective Nov. 17, 2023
Prenatal and postpartum services must be based on American College of Obstetricians and Gynecologists (ACOG) guidelines.
Grantees may bill FPP for allowable services provided in clinical prenatal care visits for women during the Medicaid for Pregnant Women and the CHIP Perinatal Program enrollment processes. See Section 9000, Resources, Reimbursable Codes for the Texas Health and Human Services Commission Family Planning Program.
Medically necessary postpartum visits are reimbursable and include interval history, physical examination, assessment, family planning, counseling, education and referral, as indicated.
Tobacco Assessment and Quitline Referral – All women receiving prenatal services should be assessed for tobacco use. Women who use tobacco should be referred to tobacco quit lines. The Texas Tobacco Quitline provides confidential, free and convenient cessation services to Texas residents ages 13 and older, including quit coaching and nicotine replacement therapy. Services can be accessed by phone at 1-877-YES-QUIT (1-877-937-7848) or online at YesQuit.org. The assessment and referral should be performed by agency staff and documented in the clinical record.
Information for Parents of Newborns Requirement
Chapter 161, Health and Safety Code, Subchapter T requires hospitals, birthing centers, physicians, nurse-midwives and midwives who provide prenatal care to pregnant women during gestation or at delivery to give the woman and the father of the infant or other adult caregiver for the infant with a resource pamphlet that includes information on:
- postpartum depression;
- shaken baby syndrome;
- immunizations;
- newborn screening;
- pertussis; and
- sudden infant death syndrome.
In addition, document in the client's chart that she received this information. The documentation must be retained for a minimum of five years. It is recommended that the information be given twice, once at the first prenatal visit and again after delivery.
Information for Parents of Newborn:
Information for Parents of Children
Chapter 161, Health and Safety Code, Subchapter T also requires hospitals, birthing centers, physicians, nurse-midwives and midwives who provide prenatal care during gestation or at delivery to pregnant women on Medicaid to provide the woman and the father of the infant or other adult caregiver for the infant with a resource guide that includes information relating to the development, health and safety of a child from birth until 5 years old. The resource guide must provide information about medical home, dental care, effective parenting, child safety, importance of reading to a child, expected developmental milestones, health care and other resources available in the state, and selecting appropriate childcare.
“A Parent’s Guide to Raising Healthy, Happy Children” is available through Texans Care for Children.
Provision of Information about Umbilical Cord Blood Donation Requirement
Chapter 162, Health and Safety Code, Subtitle H requires that a physician or other person permitted by law to attend a pregnant woman during gestation or at delivery of an infant will give the woman an informational brochure before the third trimester of the woman’s pregnancy, or as soon as reasonably feasible. It should include information about the uses, risks and benefits of cord blood stem cells for a potential recipient, options for future use or storage of cord blood, the medical process used to collect cord blood, any costs that may be incurred by a pregnant woman who chooses to donate or store cord blood after delivery, and average cost of public and private storage.
Referral and Follow-up
Grantees must have written policies and procedures for follow-up on referrals made because of abnormal physical examination or laboratory test findings. These policies must be sensitive to clients’ concerns for confidentiality and privacy and must follow state or federal requirements for transfer of health information.
For necessary services beyond the scope of the grantee, clients must be referred to other providers for care.
Whenever possible, clients should be given a choice of providers from which to select. When a client is referred to another provider or for emergency clinical care, the grantee must:
- provide pertinent client information to the referral provider and obtain required patient consent with proper safeguards to ensure confidentiality (that is, adhering to HIPAA regulations);
- advise the client about his or her responsibility to comply with the referral; and
- counsel the client about the importance of the referral and follow-up plan.