The Texas Medicaid Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program is a federally mandated health care program of prevention, diagnosis, and treatment for Medicaid recipients who are ages of birth through 20 years of age. In Texas, the EPSDT program is known as Texas Health Steps (THSteps). THSteps is administered by the Department of State Health Services (DSHS).
Through outreach, THSteps staff, or contractors encourage STAR Members to use THSteps preventive medical checkup services when they first become eligible for Medicaid/THSteps and when they are periodically due for their yearly medical checkup in their birthday month.
On request by the client, the Medical Transportation Program (MTP) assists the client with scheduling transportation. Refer to the MTP section on page 23 of this Provider Manual for more detailed information.
THSteps medical providers must perform medical checkups on any client who is currently enrolled in Medicaid and who are ages of birth through 20 years of age. Providers also are encouraged to notify the client when he or she is due for the next medical checkup according to the THSteps Periodicity Schedule.
Note: Newly enrolled STAR Members must receive a THSteps medical checkup within 60 days from enrollment.
The information in this Community First Health Plans manual is an overview that supplements the approved HHSC's version of the 2009 Texas Medicaid Provider Procedures Manual, and specifically the THSteps' Section # 43, and Texas Medicaid bi-monthly Bulletins. Providers are to refer to these documents for detailed information about the program.
Service Area
Community First's Star service area includes the following counties: Atascosa, Bexar, Comal, Guadalupe, Kendall, Medina, and Wilson.
