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¡Buenas noticias! Hemos hecho más fácil el inicio de sesión en MyChart para nuestros miembros de Texas Children’s Health Plan. Ahora puedes acceder a todas las funciones de cuidado médico de MyChart en cualquier momento y desde cualquier lugar mediante nuestro nuevo widget de inicio de sesión. Haz clic en el enlace para iniciar sesión.

Important Update Actualización importante:

Good news! All CHIP, STAR, and STAR Kids Member Handbooks are now available online. Quick, easy access to your benefits and coverage information - any time!

¡Buenas noticias! Todos los manuales para miembros de CHIP, STAR y STAR Kids ya están disponibles en línea. Obtén acceso rápido y sencillo a la información sobre tus beneficios y cobertura, ¡en cualquier momento!

Clarification of Dental Informed Consent and Treatment Plan Requirements for Deep Sedation or General Anesthesia

Date: November 4, 2026

Attention: Providers

Effective date for TMPPM’s update: December 1, 2026

Call to action: The purpose of this communication is to inform providers that HHSC is revising Section 3.2.8 of the Texas Medicaid Provider Procedures Manual (TMPPM), Children’s Services Handbook to clarify how providers should document tooth and surface IDs when they cannot reasonably be determined before deep sedation or general anesthesia.

Key details about this change:

  • Today, providers may use flexibility in the informed consent documentation to record any risks or hazards associated prior to completing a full exam and radiographs.
  • This approach aligns with 26 Tex. Admin. Code §256.6, which permits informed consent documentation to include applicable alternatives and risks.
  • The revised handbook language will further clarify this option and provide guidance for documenting these circumstances.

Background:

  • When a patient’s age, disability, medical condition, or inability to cooperate prevents a comprehensive dental exam from being completed before anesthesia, the specific tooth and surface IDs requiring treatment may not be identified until after anesthesia is administered.
  • For services provided under deep sedation or general anesthesia, the final treatment plan may be determined after reviewing examination findings, radiographs, and clinical information obtained while the client is receiving anesthesia.

How this impacts providers: Please refer to Section 3, “Texas Health Steps (THSteps) Dental” of the Texas Medicaid Provider Procedures Manual (TMPPM), Children’s Services Handbookfor more information about dental services.

HHSC plans to include the following updated language in the TMPPM’s December 1, 2026, release.

The written informed consent must identify the tooth and surface IDs associated with the proposed treatment, when these can be reasonably determined before treatment, and must include the disclosures otherwise required by this section and applicable law.

When a complete dental examination or diagnostic imaging cannot be reasonably performed prior to deep sedation or general anesthesia due to of the client's age, disability, medical condition, or inability to cooperate, the provider must document the clinical circumstances preventing identification of the specific teeth or surfaces before treatment. In these circumstances, written informed consent must still be obtained before treatment and must describe the anticipated evaluation, the types and scope of dental treatment that may be necessary based on examination findings, and the associated risks, benefits, and alternatives, consistent with applicable law and professional standards.

The provider must identify and document the tooth and surface IDs requiring treatment in a timely manner when they can be determined and maintain an accurate record of the treatment performed; however, this flexibility does not waive informed-consent requirements or authorize treatment beyond the scope of the consent obtained.

Additional Information:
The clarification is anticipated to be published in the December 2026 TMPPM release. HHSC will communicate in the case of any changes to the publication date.

Next step for Providers: Impacted providers should remain informed of HHSC updates to ensure they appropriately document patient care and make informed treatment decisions for their patients.

If you have any questions, please email Provider Relations at providerrelations@texaschildrens.org.

For access to all provider alerts www.texaschildrenshealthplan.org/provideralerts