Claims filed to TMHP must contain only one prior authorization number per claim. Prior authorization numbers must be indicated on the claim forms as indicated below:
•CMS-1500-Block 23.
•UB-04 CMS-1450-Block 63.
•ADA-Block 2.
•Family Planning-Block 30.
Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved.
CMS-1500-Block 23.