TMPPM 2007 >19.21.4 THSteps and ICF-MR Dental Prior Authorization

19.21.4 THSteps and ICF-MR Dental Prior Authorization

Submit claims, dental correspondence, and THSteps and ICF-MR prior authorization requests to the appropriate address listed in the table below:


Correspondence	Address
American Dental Association (ADA) dental claim forms	Texas Medicaid & Healthcare Partnership PO Box 200555 Austin, TX 78720-0555
All dental correspondence Prior authorization requests	Texas Medicaid & Healthcare Partnership THSteps and ICF-MR Dental Authorization PO Box 202917 Austin, TX 78720-2917

Texas Medicaid & Healthcare Partnership
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