Texas Health Steps Guidance

Case Management Services (how to make referrals)

Provider Referrals

All Medicaid managed care organizations (MCOs) provide case management services (called service management for STAR members with special health-care needs). In the other Medicaid managed care programs, everyone gets some level of case management. Patients should first be referred to the plan’s service coordinator and then referred to Case Management for Children and Pregnant Women if patient needs cannot be met by the plan’s services. Health plans are also required to make appropriate referrals to case management services.

Resources

For patients enrolled in STAR Medicaid, STAR Health, or Fee-For-Service (FFS) Medicaid, providers can make a referral by one of these methods:

  • Calling 877-847-8377 (877-THSteps).
  • Contacting a case manager (“Find a Case Manager” web page accessed from the Resources for this module).
  • Submitting the Case Management Referral Form (the form is also accessed from Resources). 

For patients enrolled in STAR Kids:

  • Health Plan service coordinators and others can refer by submitting the STAR Kids Case Management Request Form (the form is also accessed from Resources).