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Case Management for Children and Pregnant Women

Case Management for Children and Pregnant Women is a Texas Medicaid benefit for eligible patients who have medical-related needs that might affect their health care. The patients must be eligible for Medicaid and be either:

  •  A child age birth through 20 years with a health condition or at risk for a medical condition, illness, injury or disability that limits the child’s ability to function or engage in activities or social roles compared to healthy same-age peers, or
  • A pregnant woman of any age with a medical or psychosocial condition that increases the risk for pregnancy or postpartum complications.

Many of these patients have complex needs that range from specialty referrals and medical equipment/supplies to educational, psychosocial, financial and transportation services. Case managers, who are licensed social workers or registered nurses, help patients and their families connect with these services.

You can access resources that provide information on case management services from this page.

Making Referrals

Health-care providers play an important role in referring their patients with such needs for case management services. Effective September 1, 2022, patients enrolled in Medicaid managed care  receive case management services through their managed care organization (MCO). Refer patients enrolled in Medicaid managed care to contact their MCO using the phone number on the back of their insurance MCO card.  To make a referral for a patient enrolled in fee-for-service Medicaid, call 1-877-THSTEPS or obtain a Referral Form.

 

Download a Referral Form

If you are interested in becoming a case manager or would like more information, email us or visit the HHS website.

In-Person Provider Training

The pre and post-test listed below should only be completed by case management providers that have been approved by DSHS and are enrolled in or have attended the in-person case management training. 

Resources

Resources for Providers

The printed materials below are available for download in PDF format and can be ordered here.

Download Adobe Reader to view PDFs.

Case Management Brochure

English / Spanish  |  English / Vietnamese

Case Management Poster

English  |  Spanish  |  Vietnamese

Flyer for Case Management Provider Recruitment 

English

Resources for Personal Care Services

Personal Care Services (PCS) is a Medicaid benefit that helps clients with everyday tasks. These tasks are called activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

For more information, or for questions about the PCS benefit, call the Texas Medicaid & Healthcare Partnership (TMHP) PCS Client Line toll free at 1-888-276-0702, Monday through Friday, 7 a.m. to 7 p.m.

Personal Care Services (PCS) Brochure

English/Spanish