1 TAC § 382.15. Covered and Non-covered Services

(a) Covered services provided through the HTW program include:

(1) contraceptive services;

(2) pregnancy testing and counseling;

(3) preconception health screenings for:

(A) obesity;

(B) hypertension;

(C) diabetes;

(D) cholesterol;

(E) smoking; and

(F) mental health;

(4) sexually transmitted infection (STI) services;

(5) limited pharmacological treatment for the following chronic conditions:

(A) hypertension;

(B) diabetes; and

(C) high cholesterol;

(6) breast and cervical cancer screening and diagnostic services:

(A) radiological procedures including mammograms;

(B) screening and diagnosis of breast cancer; and

(C) diagnosis and treatment of cervical dysplasia;

(7) immunizations;

(8) limited pharmacological treatment for postpartum depression;

(9) health history and physical exam; and

(10) covered HTW Plus services for clients who qualify for HTW Plus as described in §382.7(b) of this subchapter.

(b) In addition to the HTW services above, covered HTW Plus services include:

(1) mental health counseling/treatment, including:

(A) individual, family, and group psychotherapy services; and

(B) peer specialist services;

(2) substance use disorder treatment, including:

(A) screening, brief intervention, and referral for treatment;

(B) outpatient substance use counseling;

(C) smoking cessation services;

(D) medication-assisted treatment; and

(E) peer specialist services;

(3) cardiovascular and coronary condition management, including:

(A) cardiovascular evaluation imaging and laboratory studies;

(B) blood pressure monitoring equipment; and

(C) anticoagulant, antiplatelet, and antihypertensive medications;

(4) diabetes management, including:

(A) laboratory studies;

(B) additional injectable insulin options;

(C) blood glucose testing supplies;

(D) glucose monitoring supplies; and

(E) voice-integrated glucometers for women with diabetes who are visually impaired; and

(5) asthma management, including:

(A) medications; and

(B) supplies.

(c) Non-covered services in the HTW program include:

(1) counseling on and provision of abortion services; and

(2) other services that cannot be appropriately billed with a permissible procedure code.