TMPPM 2010 > Behavioral Health, Rehabilitation, and Case Management Services Handbook > Mental Health Rehabilitation, Mental Health Case Management, and Mental Retardation Service Coordination > Claims Filing and Reimbursement

6.4 Claims Filing and Reimbursement

MR coordination services and MH case management and rehabilitative services must be submitted to TMHP in an approved electronic claims format or on the CMS-1500 paper claim form. Providers may purchase CMS-1500 claim forms from the vendor of their choice. TMHP does not supply them.

When completing a CMS-1500 claim form, all required information must be included on the claim, as TMHP does not key any information from claim attachments. Superbills, or itemized statements, are not accepted as claim supplements.

MHMR are cost reimbursed in accordance with 1 TAC §§355.743, 355.746, and 355.781. Providers can refer to the OFL or the applicable fee schedule on the TMHP website at www.tmhp.com.

Refer to: Section 3: TMHP Electronic Data Interchange (EDI) (Vol. 1, General Information) for information on electronic claims submissions.

Subsection 6.1, "Claims Information" in Section 6, "Claims Filing" (Vol. 1, General Information) for general information about claims filing.

Subsection 6.5, "CMS-1500 Claim Filing Instructions" in Section 6, "Claims Filing" (Vol. 1, General Information). Blocks that are not referenced are not required for processing by TMHP and may be left blank.

Subsection 2.2, "Reimbursement Methodology" in Section 2, Texas Medicaid Reimbursement (Vol. 1, General Information) for more information about reimbursement and the federal matching percentage.