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2.2 Services, Benefits, Limitations and Prior Authorization
Texas Medicaid only covers professional and technical services that an independent laboratory is certified by CLIA to perform.
Provider documentation must be maintained in the client's medical record and must delineate the medical need for administering the laboratory test.
The physician is responsible for providing to the performing laboratory the clinical diagnosis code that is associated with the individual test so that the performing laboratory may bill Texas Medicaid directly for the analysis of the specimen.
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