THSteps Policy Changes: Mental Health Screening

Effective November 1, 2015, Texas Health Steps (THSteps) will implement policy changes to mental health screening for Medicaid-eligible children.

Mental health screening is a required component of every checkup birth through 20 years of age.  In alignment with the AAP, THSteps has added the requirement that a validated and standardized mental health screening tool, approved by THSteps, be used once per lifetime for every adolescent between the ages of 12 through 18 years.  Screening can take place anytime during the age range of 12 through 18 years.  Providers may opt to use the screening tools more than once per lifetime per adolescent; however, the additional separate reimbursement for the use of this tool is available only once per lifetime per client. Effective for dates of service on or after November 1, 2015, procedure code 99420 will be reimbursed at $8.70 for fee for service providers. Documentation in the client’s medical record should indicate the screening tool used, screening results and any referrals made.

Providers must use one of the four validated and standardized mental health screening tools listed below when completing mental health screening; procedure code 99420:

  • Pediatric Symptom Checklist (PSC-35)
  • Pediatric Symptom Checklist (Y-PSC)
  • Personal  Health Questionnaire  (PHQ-9)
  • Car, Relax, Alone, Friends, Forget, Trouble (CRAFFT)

All four screening tools are available on the Bright Futures website at:

Providers may benefit from additional information on referrals to Local Mental Health Authorities (LMHAs).  LMHAs provide services in specific geographic areas of the state.  A list of local mental health authorities and their crisis hotlines is available at  Additional information on LMHAs is available on the DSHS website at