Effective February 1, 2017, the Pediatric Symptom Checklist-17 (PSC-17) may be used for adolescent mental health screening conducted during a Texas Health Steps checkup.
Screening for behavioral, social, and emotional development is required at each THSteps checkup. An additional mental health screen is required once for patients between the ages of 12 and 18. The approved screening tools are listed below:
- 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)
The approved tools can be downloaded and used at no cost to the provider.
More information on THSteps checkups and adolescent mental health screening requirements is available on the THSteps website.
Under a new collaboration between Texas Health and Human Services and the Department of Family and Protective Services (DFPS), children and adolescents should receive a Texas Health Steps medical checkup within 30 days of entering DFPS conservatorship.
Children under DFPS care receive Medicaid benefits through Superior Health Plan, a statewide managed care organization known as STAR Health. Benefits include medical, dental, vision, and behavioral health care, including prescriptions.
A Texas Health Steps checkup provided to a child during the first 30 days of DFPS care is reimbursable even if the checkup is outside the periodicity schedule.
Procedure code 99420, which is used during a THSteps checkup to administer and interpret a mental health screening tool in adolescents, is being discontinued by the 2017 HCPCS code updates. Effective January 1, 2017, THSteps providers should use procedure code 96160 or 96161 for mental health screenings in adolescents 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.
More information on THSteps checkups and preventive medical checkup diagnosis codes is available on the THSteps website.
The Texas Medicaid & Healthcare Partnership (TMHP) has updated a variety of provider enrollment applications and forms. The revised forms are available on the TMHP Forms for Medicaid Providers web page.
Effective January 1, 2017, previous versions of the forms are no longer accepted. To learn more about TMHP forms, call 1-800-302-6688.
Children and adults age 20 and younger who have disabilities and are covered by Texas Medicaid now receive services through STAR Kids.
STAR Kids provides benefits such as primary and specialty care, preventive care, hospital care, prescription drugs, personal care, and durable medical equipment and supplies. A key feature of the plan is care coordination provided through the patient’s health plan.
For more information about STAR Kids, including provider training, visit the STAR Kids web site.