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On Feb. 21, 2024, Change Healthcare experienced a cyber security incident. Any individuals impacted by this incident will receive a letter in the mail. Learn more about this from Change Healthcare, or reach out to the contact center at 1-866-262-5342.

Same-Day Texas CANS 2.0 Assessments and Psychological Testing for STAR Health

Date: 12/07/18

Superior HealthPlan, the Department of Family and Protective Services (DFPS), the Texas Health and Human Services Commission (HHSC) and a group of psychologists discussed the intent and provision of the Texas Child and Adolescent Needs and Strengths (CANS 2.0) Comprehensive (Child Welfare) Assessment and Psychological Testing. This discussion was to ensure clarity and consensus on how these different services should work together within the STAR Health program.    

Effective February 15, 2019, if a claim is billed with both a CANS 2.0 Assessment (CPT 90791, Modifier TJ) and Psychological Testing (96101-96103) on the same day, the psychological testing will be denied with a request for documentation to substantiate the appropriateness of the psychological testing performed on the same day as the CANS 2.0 Assessment.  

Please see below for directive and guidance regarding expectations of the requests for, and provision of, the CANS 2.0 and ‘same day’ psychological testing.

When should a CANS 2.0 Assessment be provided?

The CANS 2.0 Assessment is meant to be the uniform screening for all children entering foster care. The CANS 2.0 Assessment should be completed for every child 3-17 years of age who is in DFPS care. The initial assessment should be completed within 30 days of a child entering into foster care and then re-administered annually thereafter.

What are the required elements of a CANS 2.0 Assessment?

  • Presenting problems, if any.
  • Prior mental health or substance use disorder diagnoses and any prior treatment (include in the Clinical Impressions or background needs narrative section of the CANS).
  • Other pertinent medical, social, and family history (A CANS rater could create a comments box for the section or include in Background Needs section of the CANS).
  • Results of mental status examination, if indicated, and Clinical observations (include in the Clinical Impressions section of the CANS).
  • Recommendations, including expected long term and short term goals.

When should psychological testing be provided?

Psychological testing should not be considered a uniform or required assessment for all children and youth in foster care. If those services are needed, they should be scheduled after the completion of the CANS 2.0 Assessment.

A child’s placement or move to a new placement should not be uniformly dependent upon psychological testing being completed. However, these services could be necessary to address emergent symptoms, treatment complications or complex placement decisions, such as when a youth requires a more structured environment or is ready to move to a less restrictive setting.

Psychological testing should be completed for children and youth who are identified as having a specific need for further evaluation that is necessary to help determine their plan of care. For example, if there is indication or concern that the child or youth has an intellectual or other developmental disabilities, then psychological testing may be an appropriate next step after completion of the CANS 2.0 Assessment.

Can an initial CANS 2.0 Assessment and psychological testing be completed on the same day?

As a routine practice, the initial CANS 2.0 Assessment and necessary psychological testing should not be referred and/or conducted on the same day. As a routine practice, those services should be scheduled as a follow-up appointment, if there are clear indications that a child needs further evaluation after the initial CANS 2.0 Assessment is completed.

Are there any exceptions to a CANS 2.0 Assessment and psychological testing being completed on the same day?

There may be exceptions when it is in the best interest of the child to have both an initial CANS 2.0 Assessment and psychological testing completed on the same day. A few examples of exceptions that will be honored and reimbursed pending proper documentation are listed below. If you have any questions about when it is appropriate to complete a CANS 2.0 Assessment and psychological testing on the same day, please contact your designated Account Manager.

  • Court orders requesting psychological testing within the first 30 days.
  • Indication or concern of an intellectual or developmental disability that should be addressed immediately.

For more information or any questions on this process, please contact your designated Account Manager.