States Texas

Program Overview:

The Texas Department of State Health Services (DSHS) Newborn Screening (NBS) Program consists of testing, two point-of service screenings, and clinical care coordination. DSHS Laboratory provides newborn screening services in support of the Texas NBS Program, which tests about 800,000 newborn specimens each year. Texas law requires the newborn screen to help find infants who may have one of the 55 disorders or medical conditions. 

The newborn screen requires a simple heel stick blood sample collected from newborns 24 to 48 hours after birth and another at 7 to 14 days of age, a minimum of 168 hours. If the NBS detects an infant with an abnormal result, the NBS Program's Clinical Care Coordination team initiates the process of follow-up with a health care provider for confirmatory testing. If it is determined that your child has a condition, treatment will begin as appropriate.

Early detection of these 55 disorders allows early treatment that can prevent serious complications, such as growth problems, developmental delays, deafness, blindness, intellectual disabilities, seizures, and early death. The sooner treatment begins, the greater the chances your child will live a healthier life. It is important that your doctor have a current phone number or address by which to reach you in case your newborn’s screen comes back with a possible positive result. If your doctor does reach out to you about the NBS results, respond immediately and follow all instructions as quickly as possible.

How is Newborn Screening Paid for in ­­Texas?

The NBS fee is $68.63 per specimen collection kit. Health care providers or facilities purchase the specimen collection kits, which include the cost of the testing for private pay or insurance covered patients.  DSHS provides specimen collection kits at no cost to the healthcare provider for those covered by Medicaid and Children’s Health Insurance Program (CHIP) and can also be used for anyone unable to pay for newborn screening. DSHS is reimbursed by Medicaid and CHIP for the testing performed on these kits. Inability to pay should not be a barrier to getting a newborn screened.

What two point-of-service screenings are conducted at the birthing facility?

Newborn Hearing Screening

Hearing loss can affect a child’s ability to develop communication, language, and social skills. All Texas newborns should receive a hearing screening before being discharged from the birth facility. The Texas Early Hearing Detection and Intervention (TEHDI) program certifies newborn hearing screening programs and oversees statewide achievement of Early Hearing Detection and Intervention (EHDI) goals that include screening for hearing loss before 1 month of age, diagnostic evaluation before 3 months of age, and enrollment in early childhood intervention (ECI) before 6 months of age, known as the 1-3-6 benchmarks. The earlier children with hearing differences are identified and enrolled in ECI and start getting services, the more likely they are to reach their full potential.

Critical Congenital Heart Disease (CCHD) Screening

CCHD screening is a point-of service screen to determine if an infant has a serious heart condition, usually requiring surgery. The screening is done at the birthing facility, and results are available in real time. This test uses a machine called a pulse oximeter to measure how much oxygen is in a baby’s blood at different areas of circulation: before blood gets to the heart and after it pumps out of the heart. If there’s a big difference in how much oxygen is present in those two areas, it could be a sign of a congenital heart defect or disease. There is no blood test involved. Currently, Texas Health and Safety Code requires that confirmed CCHD cases be reported to the Newborn Screening Program. The CCHD Toolkit, available on DSHS Newborn Screening Program – CCHD in Texas, was developed through the Texas Pulse Oximetry Project with support from the Newborn Screening Advisory Committee.