Table of Contents
Provider Information
Front Matter
1 Provider Enrollment and Responsibilities
2 Texas Medicaid Reimbursement
3 TMHP Electronic Data Interchange (EDI)
4 Client Eligibility
5 Claims Filing
6 Appeals
7 Managed Care
Texas Medicaid Services
8 Ambulance
9 Ambulatory Surgical Center (ASC)
10 Birthing Center
11 Blind Children's Vocational Discovery and Development Program
12 Case Management for Children and Pregnant Women (CPW)
13 Targeted Case Management for Early Childhood Intervention (ECI)
14 Certified Nurse-Midwife (CNM)
15 Certified Registered Nurse Anesthetist (CRNA)
16 Certified Respiratory Care Practitioner (CRCP) Services
17 Chemical Dependency Treatment Facility (CDTF)
18 Chiropractic Services
19 Dental
20 Family Planning Services
21 Federally Qualified Health Center (FQHC)
22 Genetic Services
23 Hearing Aid and Audiometric Evaluations
24 Texas Medicaid (Title XIX) Home Health Services
25 Hospital (Medical/Surgical Acute Care Facility)
26 Independent Laboratory
27 In-Home Total Parenteral (TPN)/ Hyperalimentation Supplier
28 Licensed Clinical Social Worker (LCSW)
29 Licensed Marriage and Family Therapist (LMFT)
30 Licensed Professional Counselor (LPC)
31 Maternity Service Clinic (MSC)
32 Mental Health (MH) Mental Retardation (MR)
33 Military Hospital
34 Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS)
35 Physical Therapists/Independent Practitioners
36 Physician
37 Physician Assistant (PA)
38 Psychologist
39 Radiological and Physiological Laboratory and Portable X-Ray Supplier
40 Renal Dialysis Facility
41 Rural Health Clinics (RHCs)
42 School Health and Related Services (SHARS)
43 Texas Health Steps (THSteps)
44 Tuberculosis (TB) Clinics
45 Vision Care (Optometrists, Opticians)
Appendices
A State and Federal Offices Communication Guide
B Forms
C THSteps Forms
D Claim Form Examples
E Vendor Drug Program
F Acronym Dictionary
G HIV/AIDS
H Immunizations
I Medical Transportation
J Lead Screening
K Texas Health Steps Statutory State Requirements
L Hearing Screening Information
M THSteps Quick Reference Guide
N THSteps Dental Guidelines
O Women's Health Program
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