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2.2 Services/Benefits, Limitations, and Prior Authorization
CNMs may be reimbursed for primary care services including family planning, gynecology services, THSteps services, treatment of acute minor illnesses, chronic stable conditions provided to women throughout their lives, and to newborns for the first two months of life. CNMs may also be reimbursed for the maternity cycle care for female clients when performed in a maternity service clinic.
CNM-performed services are covered by Texas Medicaid if the services are within the scope of practice for CNMs as defined by state law, and consistent with rules and regulations made by the Texas BON or other appropriate state licensing authority.
Laboratory (including pregnancy tests) and radiology services provided during pregnancy must be billed separately from antepartum care visits. Childbirth education classes are not a benefit of Texas Medicaid.
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