TMPPM 2007 >Dear Manual User:

Dear Manual User:

Welcome to the 2008 Texas Medicaid Provider Procedures Manual. To enhance usability, this manual is available on a searchable CD-ROM and on the TMHP website at www.tmhp.com.

Note: All users who access www.tmhp.com are required to accept the American Medical Association (AMA) End-user Agreement on the use of Current Procedural Terminology (CPT). For each computer that accesses the TMHP website, the agreement must be accepted every 30 days from the last date on which the agreement was accepted by the user. If the end-user agreement is not accepted on a particular computer every 30 days, no user will be able to enter the website from that computer. For additional information about the AMA and CPT, refer to www.ama-assn.org/ama/pub/category/3113.html.

A Claims Filing Resources table is located at the end of each service section with page references to all claim instructions, appendices, Medicaid forms, and claim form examples associated with the service.

This manual contains both the Primary Care Case Management (PCCM) and Texas Health Steps (THSteps) manuals. PCCM information can be found primarily in Section Section 7, though relevant information can be found in other sections. THSteps information is contained in Section Section 43 and throughout the manual.

The Texas Medicaid Program policy published in this manual represents policy implemented as of October 31, 2007. Policy updates effective after October 31, 2007, are published bimonthly in the Texas Medicaid Bulletin.

The November/December 2007 Texas Medicaid Bulletin and all Texas Medicaid Bulletins through and including the September/October 2008 Texas Medicaid Bulletin supplement the 2008 Texas Medicaid Provider Procedures Manual and update the policy contained herein.

The Texas Medicaid Provider Procedures Manual serves as a comprehensive guide for Texas Medicaid providers, and contains information about Texas Medicaid benefits, policies, and procedures. The manual also includes an overview of the State of Texas Medicaid Managed Care programs to include the State of Texas Access Reform (STAR), STAR+PLUS, PCCM, and NorthSTAR. The information regarding the State of Texas Medicaid Managed Care programs, including Section Section 7, is not an exhaustive policies and procedures guide. For specific managed care information, contact the individual health plans participating in STAR, STAR+PLUS, and NorthSTAR. For PCCM, refer to the TMHP Telephone and Address Guide included in this manual.