Key Reminders: Texas Health Steps (THSteps) Quick Reference Guide

August 12, 2021

As a reminder, please use the appropriate codes when billing for THSteps checkups. Below are several codes we’d like to highlight. You can also reference the THSteps Quick Reference Guide Learn more about third-party links for more details.

Benefit Code EP1 should be billed for THSteps claims only

Texas Health Steps Medical Checkup Billing Codes
Use Provider Identifier – Benefit Code EP1

ICD 10 CM Diagnosis Z23 must be use when Immunization administered

Immunizations Administered
Use code Z23 to indicate when immunizations are administered.

Modifiers which must be included to get receive reimbursement

Federally qualified health center (FQHC) providers must use modifier EP for Texas Health Steps medical checkups. Rural health clinics (RHC) providers must bill place of service 72 for Texas Health Steps medical checkups.

Procedure codes and Diagnosis which must be included to receive reimbursement:

Texas Health Steps Medical Checkups
99381 99382 99383 99384 99385*
99391 99392 99393 99394 99395*
*For clients who are 18 through 20 years of age, use diagnosis code Z0000 or Z0001.

Texas Health Steps Follow-up Visit
Use procedure code 99211 for a Texas Health Steps follow-up visit

ICD-10 Diagnosis Codes
Z00110 Routine newborn exam, birth through 7 days
Z00111 Routine newborn exam, 9 through 28 days
Z00129 Routine child exam
Z00121 Routine child exam, abnormal
Z0000 General adult exam
Z0001 General adult exam, abnormal


For questions or additional information, please contact our BCBSTX Medicaid Provider Service Center at 1-877-560-8055 or your Texas Medicaid Network team at 1-855-212-1615 or via email  Texas Medicaid Network Department.

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.

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