Medicaid and CHIP Services Information for Providers | Texas Health and Human Services - Texas Health and Human Services |

Medicaid CHIP COVID-19 Information Sessions

Beginning May 6, 2021, HHSC will post pre-recorded sessions monthly. These sessions will continue to share information with stakeholders about the implementation of various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic. HHSC may return to weekly sessions as needed if there are changes to the public health emergency.

WHEN:

 Nov. 4, 2021

Dec. 2, 2021

Medicaid and CHIP Flexibilities

Any changes to Medicaid and CHIP services will be posted here and sent out through standard communication channels.

Be sure to check health plan provider portals, the TMHP COVID-19 page, and read any emails you get from HHSC.

As noted in the sections below, multiple Medicaid and CHIP flexibilities have been extended through December 31, 2021.

More information will be provided if there are changes.

Testing for COVID-19

Healthcare providers should coordinate with local public health authorities to determine whether a patient needs to be tested for COVID-19.

Coverage

• Medicaid and CHIP will cover COVID-19 testing for Medicaid and CHIP clients.
• No prior authorization will be required on the COVID-19 lab test by Medicaid and CHIP health plans or by traditional Medicaid.

For information on the testing and treatment of the uninsured for COVID-19 see the resources section of this page.

Billing Codes

The Centers for Medicare & Medicaid Services (CMS) has issued two new HCPCS codes for use by providers who are testing patients for COVID-19. Providers can submit these codes for dates of service on or after Feb. 4, 2020:

• U0001 – The CDC-developed test kit
• U0002 – A laboratory test that is not the CDC-developed test kit (any technique)

For more details see the TMHP bulletins issued on March 16 (PDF) and the bulletin issued on June 4 (PDF).

The American Medical Association (AMA) has created a new CPT code for use on or after March 13, 2020:

• 87635 – A laboratory test that is not the CDC-developed test kit (amplified probe technique)

For more details see the TMHP bulletin issued on June 4 (PDF).

Tests using high-throughput technologies

CMS has issued two new HCPCS codes for lab tests that use high-throughput technologies to test for COVID-19. Providers can submit these codes for dates of service on or after April 14, 2020:

• U0003 – A laboratory test performed using high-throughput technologies that is not the CDC-developed test kit (amplified probe technique)
• U0004 – A laboratory test performed using high-throughput technologies that is not the CDC-developed test kit (any technique)

For more details see the TMHP bulletin issued on June 4 (PDF).

Tests for COVID-19 Antibody (serologic)

AMA announced one revised CPT code and two new CPT codes that providers can submit for antibody testing for dates of service on or after April 10, 2020:

• 86318 – Multiple infectious agents antibody testing performed using a single-step method immunoassay (Revised - see further information in this TMHP bulletin (PDF))
• 86328 – COVID-19 Antibody testing performed using a single-step method immunoassay
• 86769 – COVID-19 Antibody testing performed using a multiple-step method

For more details see the TMHP bulletin issued on June 4 (PDF).

Reporting specimen collection

CMS has issued two new HCPCS codes for COVID-19 specimen collection. Laboratories can submit these codes for dates of service on or after March 1, 2020:

• G2023 - Specimen collection, any specimen source (for use by laboratories only)
• G2024 - Specimen collection from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency, any specimen source (for use by laboratories only)

For more details see the TMHP bulletin issued on June 4 (PDF)

All other providers may continue to bill for the COVID-19 specimen collection using one of these codes:

• 99001 - Handling and/or conveyance of specimen
• 99211 – Established office visit not requiring the presence of a physician

Reimbursement Rates

TMHP has provided reimbursement rate updates for procedure codes related to COVID-19. These rates are effective for the duration of the federal emergency declaration.
For more details, see the TMHP bulletin issued on June 26, 2020 (PDF).

Vaccinations for COVID-19

Vaccine Administration Procedure Codes

Pfizer-BioNTech

On Dec. 11, 2020, in accordance with the FDA's issuance of Emergency Use Authorization for the Pfizer-BioNTech COVID-19 Vaccine, vaccine administration procedure codes 0001A and 0002A are benefits for Texas Medicaid for individuals 16 years of age and older. Vaccine procedure code 91300 is informational only while the vaccine is distributed to providers free of charge.

Read the TMHP bulletin issued on December 14.

Effective May 10, 2021 coverage was expanded to include individuals 12 years of age and older.

Read the TMHP bulletin issued on May 11, 2021.

Moderna

On Dec. 18, 2020, in accordance with the FDA's issuance of Emergency Use Authorization for the Moderna COVID 19 Vaccine, vaccine administration procedure codes 0011A and 0012A are benefits for Medicaid, Healthy Texas Women, Family Planning Program and the Children with Special Health Care Needs Services Program for individuals who are 18 years of age and older. Vaccine procedure code 91301 is informational only while the vaccine is distributed to providers free of charge.

Read the TMHP bulletin issued on December 18.

Janssen

On Feb. 27, 2021, in accordance with the FDA's issuance of Emergency Use Authorization for the Janssen COVID 19 Vaccine, vaccine administration procedure code 0031A is a benefit for Medicaid, Healthy Texas Women, Family Planning Program and the Children with Special Health Care Needs Services Program for individuals 18 years of age and older. Vaccine procedure code 91303 is informational only while the vaccine is distributed to providers free of charge.

Read the TMHP bulletin issued on February 27.

Additional Vaccine Doses

Effective Aug. 12, 2021, the FDA issued an amended Emergency Use Authorization for the use of an additional dose of the Pfizer-BioNTech and Moderna COVID-19 vaccines in certain immunocompromised individuals.

Read the TMHP bulletin issued on August 24, 2021.

Effective Sept. 22, 2021, the FDA issued an amended Emergency Use Authorization for vaccine administration code 0004A, the booster dose of the Pfizer-BioNTech COVID-19 vaccine.

Read the TMHP bulletin issued on October 15, 2021.

Effective October 20, 2021, the FDA issued amended Emergency Use Authorizations for vaccine administration codes 0034A and 0064A, the booster doses of the Janssen/Johnson & Johnson and Moderna COVID-19 vaccines, respectively.

Read the TMHP bulletin issued on November 15, 2021.

In-home Vaccination

Effective June 8, 2021, COVID-19 vaccine administration add-on procedure code M0201 is now a benefit of Medicaid. Procedure code M0201 is an add-on procedure code for use when a COVID-19 vaccine is administered in the home setting and is the only service provided in the same home on the same date.

For more details see the TMHP bulletin issued on Sept. 16, 2021.

Federally Qualified Centers and Rural Health Clinics

Effective March 23, 2021, Federally Qualified Health Center (FQHC) and Rural Health Clinic (RHC) providers may be reimbursed for COVID-19 vaccine administration services rendered in the office, outpatient hospital, and other location settings.

For details, see the TMHP bulletin issued on April 19, 2021.

Become a COVID-19 Vaccinator

The Department of State Health Services (DSHS) is actively recruiting providers to serve as COVID-19 vaccinators.

Interested providers should visit the Provider Vaccine Information webpage on the DSHS website.

Receiving a COVID-19 Vaccine

Some Medicaid providers may be eligible to receive a COVID-19 vaccine. Find out more on the DSHS COVID-19 Vaccine Information webpage.

Vaccine Resource for Consumer Directed Services

HHSC is providing a resource for CDS employees experiencing challenges accessing the COVID-19 vaccine because they do not have a badge or photo ID verifying their health care worker status.

The resource template is attached to IL 2021-06 (PDF). FMSAs can complete and provide to CDS employees to assist in verifying they are home health care workers.

Treatment services

CMS issued a fact sheet for COVID-19 treatment services covered by Medicaid here.

For information on coding related to COVID-19 diagnosis refer to the following TMHP bulletins:

For information on the testing and treatment of the uninsured for COVID-19 see the resources section of this page.

Teleservices

Medicaid and CHIP health plans have flexibility to provide teleservices, including in a member's home. HHSC has encouraged health plans to take advantage of these options when responding to COVID-19.

No additional enrollment is required to provide telemedicine medical services or telehealth services. For more information read the TMHP bulletin issued on March 16.

For details on telehealth services for occupational, physical, and speech therapy read the TMHP bulletin issued on April 24.

Billing for telephone (audio-only) services

For services delivered on March 20, 2020 through December 31, 2021:

• Providers may bill codes 99201-99205 and 99211-99215 for telephone (audio-only) medical (physician delivered) evaluation and management services delivered.
• Providers may bill to receive Medicaid reimbursement for the following behavioral health services delivered by synchronous audio-visual technologies, including web-based video software, or telephone (audio-only):
  • Psychiatric Diagnostic Evaluation (90791, 90792).
  • Psychotherapy (90832, 90834, 90837, 90846, 90847, 90853).
  • Peer Specialist Services (H0038).
  • Screening, Brief Intervention and Referral to Treatment (H0049, G2011, 99408).
  • Substance Use Disorder Services (H0001, H0004, H0005).
  • Mental Health Rehabilitation services (H0034, H2011, H2012, H2014, H2017).

Read the TMHP article for details (PDF).

Providers should use the nationally defined 95 modifier for telemedicine and telehealth service claims to indicate that remote delivery occurred.

Federally Qualified Health Centers

To help ensure continuity of care during the COVID-19 response, HHSC will reimburse Federally Qualified Health Centers (FQHCs) as telemedicine (physician-delivered) and telehealth (non-physician-delivered) service distant site providers. Read the TMHP article for full details. 

Effective December 1, 2020, FQHCs may be reimbursed as telemedicine and telehealth distant site provider as permanent policy change.

Rural Health Clinics

Rural Health Clinics (RHCs) may be reimbursed as telemedicine and telehealth distant site providers statewide for service dates from March 24, 2020 through December 31, 2021. For more information read the TMHP bulletin issued on April 24.

Case Management

Case management may be delivered through synchronous audio-visual technologies or telephone (audio-only). Providers should bill procedure code T1017 using the 95 modifier to indicate that remote delivery occurred.

Read the TMHP Bulletin from April 24 (PDF) for more information. This is effective through December 31, 2021.

CLASS Professional and Specialized Therapies

Due to COVID-19, certain CLASS professional and specialized therapy services may be provided by telehealth. This is effective through December 31, 2021.

Read the HHSC alert posted on March 26, 2021 for more information.

Nursing Services for CLASS, DBMD, HCS and TxHmL

Due to COVID-19, HHSC will allow a nursing assessment, including a comprehensive nursing assessment, to be done through telehealth for individuals enrolled in the waiver programs.

Read the HHSC alert posted on April 21 for more information.

Hospice Services

Effective November 9, 2021 Medicaid hospice providers must resume face-to-face reassessments, as required in the 40 TAC Section 30.14(e)(1), Certification of Terminal Illness and Record Maintenance.

Read the HHSC IL (PDF) posted on September 13, 2021 for more information.

CHIP Co-Payments

Medical office visit co-payments are waived for all CHIP members for services provided from March 13, 2020 through January 31, 2022. Co-payments are not required for covered services delivered via telemedicine or telehealth to CHIP members.

Provider Reimbursement

The member's MCO will reimburse the provider the full rate for the service, including what would have been paid by the member through cost-sharing. Providers must attest that the medical office visit co-payment was not collected by using the attestation form and submitting an invoice to the appropriate MCO or by submitting a detailed claim that includes the co-payment amount of each claim transaction for services provided in which co-payments were not collected. MCOs have 30 calendar days to pay an invoice received from a provider.

Electronic Visit Verification Policy Updates

Existing EVV Providers
HHSC is issuingtemporary EVV policies (PDF) in response to COVID-19. The temporary policies are effective March 21, 2020 through December 31, 2020 unless noted in the PDF. The temporary policies will not be extended after Dec. 31, 2020.

For dates of service beginning on Jan. 1, 2021, EVV claims matching with denials will resume, and claims will no longer receive an EVV07 match code in the EVV Portal.

Program providers: 

• Must ensure a matching EVV visit transaction is accepted in the EVV Portal before billing the claim, or the claim will be denied.
• Will no longer have 180 days to complete visit maintenance. 
• Should continue to follow the Best Practices for Temporary Policies for COVID-19 to avoid recoupments for claims with dates of service from March 21, 2020 to Dec. 31, 2020.

Extra Medicine or Supplies

On March 19, 2020, the Texas State Board of Pharmacy authorized pharmacists in Texas to dispense up to a 30-day supply of medication (other than a schedule II-controlled substance) for patients in Texas in the event a prescriber cannot be reached in response to the state of disaster declaration for COVID-19. Beginning August 1, 2021 pharmacies will no longer provide early refills.

Drug Shortages

Visit the Vendor Drug Program website for any temporary changes made to the preferred drug list due to reported drug shortages.

Providers should complete the Drug Shortage Notification (HHS Form 1315) to inform HHSC of potential shortages impacting prescribing choice or pharmacy claim processing.

In-Home Service Delivery

Home health agencies and certified providers of long-term services and supports (LTSS) delivered through either a Medicaid waiver or state plan program are required to have backup plans in place. These plans include provisions for when an in-home care provider cannot work because they are sick.

If a backup plan is not currently in place, providers must work with clients or their legally authorized representatives (LARs) to develop one.

• Providers in managed care may need to coordinate with members' service coordinators to ensure backup plans are comprehensive.
• Providers employed by an individual using the Consumer Directed Services (CDS) option should work with their CDS employer, MCO, program service coordinators or case managers to develop a backup plan.

CDS employers can continue to allow service providers, such as personal attendants, to enter their home to provide services. Refer to IL 2020-08 for more information.

Financial Management Services Agencies (FMSAs) can assist to make any necessary CDS budget revisions.

Temporary Change on Living in Same Home Prohibitions

HHSC temporarily lifted the prohibition on service providers of respite and CFC PAS/HAB from living in the same home as the person receiving Home and Community-based Services and Texas Home Living program services.

More information about temporary changes to this policy are available in the bulletin issued on March 26, 2021. This guidance is effective through December 31, 2021.

Appeals and Fair Hearings

Appeals

In response to COVID-19, HHSC requires all MCOs, DMOs and MMPs to extend the timeframes for the number of days members, legally authorized representatives or authorized representatives can request an appeal through December 31, 2021:

• Normally 60 days to request an MCO internal appeal, now 90 days.

The timeframe to request continuation of benefits upon receipt of the adverse benefit determination was extended to 30 days through June 30, 2021. Effective July 1, 2021, MCOs, DMOs and MMPs must enforce the normal, regular and established timeframes that members have to request for continuation of benefits, which is the later of 10 days from the date the MCO notice of adverse benefit determination is mailed or the date services will change.

HHSC also requires all MCOs, DMOs and MMPs to accept oral requests for appeals without the member having to provide a written request through December 31, 2021.

Fair Hearings

In response to COVID-19, HHSC is also extending the timeframes for the following through December 31, 2021:

• Number of days members, legally authorized representatives or authorized representatives have to request a fair hearing.
  • Normally 120 days to request a fair hearing after the internal MCO appeal, now 150 days.
    If the timeframe for a member to request a fair hearing would have expired in December 2021, they will have an extra 30 days from that expiration date to request a fair hearing.
• Number of days HHSC has to make a fair hearing determination.
  • Normally fair hearings determinations are made within 60 - 90 days of the date HHSC receives a request for a fair hearing, now 120 days.

Managed Care: Face to Face Visits

Service coordination visits

Effective immediately MCOs may allow service coordination visits to be completed in person when requested by the member receiving services. Telehealth should be the primary modality for service coordination visits if in-person is not feasible. Beginning September 1, 2021 MCOs must offer service coordination visits in person when requested by the member receiving services.

For all members, including those with levels of care and ISPs that have been extended, MCOs and MMPs must continue to conduct service coordination and service planning telephonic or telehealth visits to ensure members are receiving needed services.

MCOs and MMPs are required to conduct the same number of contractually required annual outreach contacts, at this time. This applies to facility and community members.

All MCOs and MMPs may use telehealth or telephonic processes to:

• Coordinate discharge planning for members transitioning from hospitals.
• Conduct joint meetings with Local Intellectual and Developmental Disability Authorities (LIDDAs), Case Management Agencies and Direct Service Agencies.
• Allow providers to provide mental health targeted case management services.
• Conduct Screening and Assessment Instruments (SAIs) and Individual Service Plans (ISPs) for STAR Kids members not in the Medically Dependent Children's Program (MDCP).

Extended enrollment MDCP and STAR+PLUS HCBS

To ensure members do not experience a gap in services due to the temporary suspension of face to face service coordination visits for COVID-19, HHSC is extending enrollment in the Medically Dependent Children's Program (MDCP) and STAR+PLUS Home and Community Based Services (HCBS) for members with an ISP expiring from April 2020 through December 2020 for 12 months from the original ISP end date.

Telehealth Assessments

STAR+PLUS HCBS and MDCP interest list releases were suspended beginning in April 2020. STAR+PLUS HCBS interest list releases resumed in February 2021. MDCP interest list releases resumed in October 2021.

Effective immediately MCOs may to conduct initial MDCP and STAR+PLUS HCBS waiver assessments in person when requested by the member. Telehealth should be the primary modality for the assessments if in-person is not feasible. Telephone may only be used as a last resort.

Beginning September 1, 2021 MCOs must offer waiver assessments in person when requested by the member.

This guidance is for the following groups

• Individuals who were released from STAR+PLUS HCBS or MDCP interest lists prior to the interest list release suspension.
• STAR+PLUS HCBS releases beginning in February 2021.

MCOs must start conducting level of care reassessments via telehealth for members with ISPs expiring December 30, 2020 and moving forward. Telephone may only be used as a last resort. ISPs that would have expired through December 31, 2020 have been extended for 12 months. Even if the reassessment results in a denial, eligibility for the waiver will be maintained through the length of the pandemic to comply with maintenance of eligibility requirements in H.R. 6201.

MCOs and MMPs will process a change in condition, including submission of a medical necessity level of care (MNLOC) or screening and assessment instrument (SAI), when it is identified there is a change in the member's service needs.

Nursing facility MDS authorization extensions

HHSC extended nursing facility minimum data set (MDS) assessment authorizations by 90 days for those expiring from April 2020 to May 9, 2021. Effective May 10, 2021, MDS assessments will no longer be extended.

For more information, read the TMHP bulletin posted on August 6 (PDF).

FMSA Orientations

HHSC directed STAR, STAR Health, STAR Kids, and STAR+PLUS MCOs to allow FMSAs to suspend providing face-to-face orientations for CDS employers through January 31, 2022. Employer orientations scheduled through the end of January 2022 will be virtual or by telephone.

Effective February 1, 2022, FMSAs can permanently conduct new employer orientation virtually (i.e. audio-visual) in addition to allowing in-person orientations, based on member preference.

Upgrades for STAR+PLUS members who left a nursing facility without HCBS in place

HHSC is allowing STAR+PLUS MCOs and MMPs to use the existing process for requesting upgrades to STAR+PLUS HCBS for members who exited a nursing facility (NF) on or after March 18, 2020, due to concerns about COVID-19 or in accordance with local orders during the early stages of the public health emergency, without HCBS in place. MCOs and MMPs are currently identifying and informing eligible members of the option to upgrade and conducting the STAR+PLUS HCBS Program medical necessity/level of care (MN/LOC) assessment for program eligibility.

Providers should direct STAR+PLUS and MMP members who were discharged from a NF on or after March 18, 2020, currently do not reside in a NF, and still have NF Medicaid to their MCOs for more information about the option to upgrade to STAR+PLUS HCBS.

IDD Waivers and Other Services: Face to Face Visits

Service coordination visits

Effective immediately MCOs may allow service coordination visits to be completed in person when requested by the member receiving services for the following groups:

• Fee-for-service Medicaid 1915(c) waiver case managers and service coordinators for Community Living Assistance and Support Services (CLASS), Texas Home Living (TxHmL), Deaf-Blind with Multiple Disabilities (DBMD) and Home and Community-based Services (HCS)
• General Revenue service coordinators
• Community First Choice service coordinators
• Preadmission Screening and Resident Review (PASRR) habilitation coordinators

Telehealth should be the primary modality for service coordination visits if in-person is not feasible. Beginning September 1, 2021 MCOs must offer service coordination visits in person when requested by the member receiving services.

Eligibility extensions

To ensure members do not experience a gap in services due to the temporary suspension of face to face service coordination visits for COVID-19, HHSC is extending Intellectual Disability/Related Condition (ID/RC) assessments and individual plans of care (IPC) through December 30, 2020. HHSC will not automatically renew IPCs and ID/RC assessments expiring on or after December 31, 2020. This guidance is for individuals who are enrolled in the following programs:

• Community Living Assistance and Support (CLASS)
• Deaf Blind with Multiple Disabilities (DBMD)
• Home and Community-based Services Program (HCS)
• Texas Home Living (TxHmL)

As a reminder, electronic signatures are allowed in accordance with TAC Chapter 49.305 (j). Additional guidance related to COVID-19 allowances can be found in the information letters below.

For reference:

HCS and TxHmL: IL 2020-45 (PDF)

CLASS and DBMD: IL 2020-46 (PDF)

FMSA Orientations

FMSAs may suspend providing face-to-face orientations for CDS employers through January 31, 2022. Employer orientations scheduled through January 2022 will be virtual or by telephone. 

Effective February 1, 2022, FMSAs can permanently conduct new employer orientation virtually (i.e. audio-visual) in addition to allowing in-person orientations, based on member preference.

Supervisory Visits

Community Attendant Services, Family Care, and Primary Home Care providers may suspend face to face supervisory visits and instead conduct interdisciplinary team (IDT) meetings by telephone or by video (virtually)- through August 22, 2021. Beginning August 23, 2021 face to face visits will be required.

For reference:

IL 2020-16 (PDF)

Provider Enrollment

Revalidation Changes

Effective February 28, 2022, HHSC is ending the flexibility that extended revalidation dates due to the COVID-19 public health emergency.

For more information, read this TMHP bulletin issued on Nov. 1, 2021.

Expedited Enrollment

Providers may use the Public Health Emergency Enrollment Application until July 31, 2021. Beginning August 1, 2021 providers must return to the normal enrollment application process. For more information, read this TMHP bulletin issued on April 1 (PDF).

Fingerprinting Exemptions

Effective September 1, 2021, the Public Health Enrollment exemptions for the submission of proof of fingerprinting and undergoing pre-enrollment and post-enrollment site visits will end. Providers that require proof of fingerprinting and pre and post site visits will no longer be exempt from these requirements.

Off-Site Facility Application

In response to the COVID-19 public health emergency, hospitals that have received approval from HHSC via the Health and Human Services COVID-19 Off-Site Facility Application can add alternate physical addresses for temporary off-site facilities.

For more information, read the TMHP bulletin issued on April 20.

Prior Authorizations

Extensions to Existing Prior Authorizations

To help ensure continuity of care during the COVID-19 response, HHSC has directed MCOs and MMPs to extend for 90 days existing prior authorizations and service authorizations that require recertification and are set to expire through December 31, 2020, after which time the 90-day prior authorization extensions will come to an end. 

This extension does not apply to current authorizations for one-time services or pharmacy PAs. For example, a single non-emergency ambulance trip would not be extended, but a recurrent non-emergency ambulance authorization for dialysis would be extended.

This extension applies to all state plan services requiring recertification, including acute care and long-term services and supports such as personal assistance services, personal care services, community first choice, private duty nursing, physical, occupational and speech therapies, and day activity and health services. This extension also applies to clinician administered drugs (CADs), when clinically appropriate.

Read the TMHP bulletin posted on April 9 for more details.

New and Initial Prior Authorizations

HHSC has directed TMHP to move forward with processing new and initial prior authorization (PA) requests, including recertification requests, by relaxing document submission timeframes for providers if they are unable to provide certain required documentation through December 31, 2021.

Beginning with dates of service January 1, 2022 and after, all pre-COVID prior authorization timeframe and submission requirements will resume as outlined in the Texas Medicaid Provider Procedures Manual (TMPPM).

This guidance applies to all state plan services, including acute care and long-term services and supports such as personal assistance services, personal care services, Community First Choice, private duty nursing, day activity and health services, and durable medical equipment and supplies. Medical necessity-related documentation of clinical records to demonstrate patient status and progress specific to some services is still required.

Providers must submit the appropriate PA forms for requesting services, including the procedure and diagnosis codes, applicable modifiers, dates of service, and numerical quantities for services requested.

Read the TMHP bulletin posted on Oct. 25, 2021 (PDF) for more details.

Texas Health Steps Comprehensive Care Program

To comply with House Resolution (H.R.) 6201(116th Congress, 2019-2020; Public Law No:116-127), state Medicaid programs cannot terminate or reduce access to benefits available to beneficiaries beginning March 18, 2020, through the end of the public health emergency.

HHSC has directed MCOs and DMOs to ensure members who turn 21 on or after March 18, 2020 continue to have access to Early and Periodic Screening, Diagnosis, and Treatment (EPDST) services through the public health emergency.

Texas Health Steps Checkups

To limit exposure to COVID-19 and allow providers to focus on acute care, HHSC encourages medical and dental providers to make decisions on adjusting clinical operations based on professional medical judgement and/or guidance from professional medical and dental societies. This should include considering the risk of exposure to COVID-19 at the local and community

Read the TMHP bulletin posted on April 1 (PDF) for more details.

To allow for continued provision of THSteps checkups during the period of social distancing due to COVID-19, HHSC is allowing remote delivery of certain components of medical checkups for children over 24 months of age (i.e. starting after the "24 month" checkup). Because some of these requirements, like immunizations and physical exams, require an in-person visit, providers must follow-up with their patients to ensure completion of any components within 6 months of the telemedicine visit.

For details, read the TMHP Bulletin issued on May 12 (PDF). This is effective through December 31, 2021.

For answers to common questions, read the Texas Health Steps Telemedicine Guidance for Providers (PDF), updated on June 16, 2020.

School and Health Related Services

School Health and Related Services (SHARS) are provided to students with a disability to ensure individuals benefit from special education programs.

During any temporary closure of schools for in-person classroom attendance, schools may continue to provide instruction using alternative methods of delivery. Read the TMHP Bulletin posted April 24 (PDF) for more details.

Beginning July 1, 2021, SHARS providers will no longer get the Certification of Funds (COF) letter through email in addition to the mailed letter. Read the TMHP Bulletin posted on June 14 (PDF) for details.

If schools are unable to provide instruction using alternative methods of delivery, providers can work with MCOs to ensure clients have access to needed services during this time.

Delivery of Durable Medical Equipment

Guidelines on waiving signature requirements for Durable Medical Equipment (DME) are outlined in this TMHP Bulletin (PDF). This is effective through December 31, 2021.

Beginning with dates of service on or after January 1, 2022, this flexibility will end, and the client or guardian signature requirement for the DME Certification and Receipt Form will resume.

Past Information Sessions

For older handouts and recordings, email Medicaid CHIP.

• Oct. 7, 2021
• September 2, 2021
• August 5, 2021