TMPPM 2008 > Texas Medicaid Services > Family Planning Services > Procedure Codes and Reimbursement Amounts

    
 

20.7.6 Drugs and Supplies

Procedure Code
Title V and XX Fee
Title XIX Fee

9-A4261

$24.22
$24.22

9-A4266

$10.01
$10.01

9-A4267

$0.22
$0.22

9-A4268

$2.00
$2.00

9-A4269

$4.00
$4.00

1-A9150* with modifier FP

$14.00
NA

1-J1055

$48.10
$48.10

1-J3490

$5.90
$5.01

1-J7303

$35.80
$40.65

1-J7304

$10.62
$15.36

1-S4993

$2.80
$2.80

1-90772**

NA
$2.15
* Title V and Title XX only. For Title XIX, clients are provided a prescription to be filled through the Vendor Drug Program.
** Title XIX only. Not a payable benefit for Titles V and XX.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2007 American Medical Association. All rights reserved.
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