Open Enrollment for Newborn Screening Benefits

Open Enrollment for Newborn Screening Benefits is sponsored by Texas Department of State Health Services (DSHS). The Texas Department of State Health Services (DSHS) is requesting applications to provide services to eligible clients for the newborn screening program.

Newborn Screening Benefits Program | Texas DSHS Newborn Screening Benefits Program This page provides information about Newborn Screening Benefits Program Newborn Screening Program Newborn Screening Program Texas Early Hearing Detection and Intervention (TEHDI) Approved Screening Equipment Frequently Asked Questions Resources for Health Care Providers Pediatric Audiology Service Providers About Us - Newborn Screening Program Saving Babies with Texas Newborn Screening Newborn Screening Testing: For Your Baby's Health Newborn Screening Educational Materials Newborn Screening Parent Resources 10 Things Parents Want to Know About Newborn Screening Congenital Adrenal Hyperplasia (CAH) Congenital Adrenal Hyperplasia: A Handbook for Parents Hypothyroidism and Your Infant Severe Combined Immunodeficiency (SCID) Newborn Screening Program Frequently Asked Questions Critical Congenital Heart Disease (CCHD) Critical Congenital Heart Disease (CCHD) - Frequently Asked Questions Critical Congenital Heart Disease (CCHD) in Texas More About Sickle Cell Disease Sickle Cell Anemia: A Parent's Guide for the School Age Child Pain in the Child with Sickle Cell Disease Hemoglobin Sickle C Disease Sickle Cell Anemia and Stroke Sickle Beta Zero Thalassemia Pneumococcal Infection and Penicillin Splenic Sequestration Crisis Sickle Cell Advisory Committee Resources for Health Care Providers Newborn Screening Clinical Care Coordination- Specimen Collection Screening the Critically Ill and Premature Infants Newborn Screening Advisory Committee Clinical Care Coordination Consultants Newborn Screening Benefits Program Toll-free (ext.

776-3957) Newborn Screening Benefits Program Contractors Providing Benefits The Department of State Health Services (DSHS) works with contractors to provide newborn screening benefits and services to eligible clients in Texas using Newborn Screening Program (NBS) Benefits.

To provide these approved services and benefits, contractors are required to understand and be knowledgeable of terminology, eligibility screening requirements and processes as well as comply with specific federal and state laws and procedures. The NBS Benefits Contractor Procedures Manual and Supplement Benefits Lists provide important information to contractors.

NBS Benefits reimburses enrolled providers for the provision of specified services to eligible clients in accordance with the NBS Program rules. The contractor manual describes benefit provider qualifications, the client eligibility process, and billing and reimbursement. The supplements to the manual are separately posted to allow for ease of updating as needed.

NBS Benefits Contractor Procedures Manual (effective 9/1/2024) NBS Benefits Contractor Procedures Manual (through 8/31/2024) Contractor Manual Supplement – Laboratory Services Contractor Manual Supplement – Allowable Benefits List NOTE: NBS Benefits is a payer of last resort.

This means that all applicants first must apply for Medicaid, Children's Health Insurance Program (CHIP), and Children with Special Health Care Needs (CSHCN) before applying for NBS Benefits.

Infants, children, and adults are prioritized by need as funds are available and meet the following: Have income at or below 350% of Federal Poverty Income Level Are diagnosed with disorder identified by Newborn Screening Program Are a bona fide resident of the State of Texas Have an annual renewal review Are ineligible for other programs providing the same services such as: Children with Special Health Care Needs (eligible if on waiting list) Children’s Health Insurance (CHIP) program Dietary supplements, metabolic foods (formulas), and low-protein foods Confirmatory testing, evaluation, and follow-up care Reimbursement to specialists for telephone consults Medical geneticists and clinics Centers specializing in metabolic, endocrine and hematological disorders Laboratories that provide confirmatory testing Pharmacies that provide vitamins, medications, dietary supplements (metabolic foods) Manufacturers or retailers of medical foods that provide low-protein foods, formulas, dietary supplements, and vitamins Newborn Screening Program Benefits Forms Application for Newborn Screening Benefits Services (English) Application for Newborn Screening Benefits Services (Spanish) Authorized Representative Form for Newborn Screening Benefits (English) Authorized Representative Form for Newborn Screening Benefits (Spanish) Prior Approval Request Form Prescription Request Form (New/Add/Change) Presumptive Eligibility Application Statement of Applicant’s Rights And Responsibilities Monthly Billing and Report Forms State of Texas Purchase Voucher (Word) Monthly Billing – Low-Protein Foods Monthly Billing – Pharmacy/Medical Foods Provider Low Protein Foods Approval Request (New Items/Prices) Statement of Self-Employment Income Employment Verification – Release of Information Email nbsbenefits@dshs.

texas. gov if you have questions about NBS program benefits or need open enrollment information.