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5.16 Children's Health Insurance Program (CHIP) Perinatal Claims
Inpatient services under CHIP Perinatal for unborn children and women between zero and 185 percent of the federal poverty level (FPL) will be reimbursed as follows:
For women with income at or below 185 percent FPL:
• Hospital facility charges paid through Emergency Medicaid and processed by TMHP.
•Professional service charges paid and processed through CHIP.
For newborns with a family income at or below 185 percent FPL:
•Hospital facility charges paid through the CHIP Perinatal Program and processed by TMHP.
•Professional service charges are paid and processed through CHIP.
Inpatient services (limited to labor with delivery) for unborn children and women with income between 186 and 200 percent of FPL will be covered under CHIP Perinatal, and these claims will be paid by the CHIP Perinatal health plan.
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