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2.2 Reimbursement Methodology
The Texas Medicaid Program reimburses providers using several different reimbursement methodologies, including fee schedules, reasonable cost with interim rates, hospital reimbursement methodology, provider-specific encounter rates, reasonable charge payment methodology, and manual pricing. Each Texas Medicaid Program service describes the appropriate reimbursement for each service area.
Note: Medicaid reimbursement through the State of Texas Access Reform (STAR), STAR+PLUS, and NorthSTAR Program health plans may differ according to the provider's contract with the health plan.
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