TMPPM 2008 > Texas Medicaid Services > Family Planning Services > Procedure Codes and Reimbursement Amounts

20.7.8.2 Tubal Ligation

Procedure code 1/2-58600 must be used for any sterilization procedure performed on a female client by a family planning agency using Title V, X, XIX, or XX. This procedure code is paid as a global fee to include preoperative, intraoperative, and postoperative services by all parties involved, (i.e., physician, anesthesiologist, facility, laboratory, etc.). Sterilizations are considered to be permanent, once per lifetime procedures. When a client's claim history shows a previous sterilization, providers are asked to appeal and must provide supporting documentation for the need for repeat sterilization. Per federal regulation 42 Code of Federal Regulations (CFR) 50, Subpart B, all sterilization procedures require an approved Sterilization Consent Form.

For a complete list of Title XIX sterilization procedures, providers should refer to the Texas Medicaid fee schedules located on the TMHP website at www.tmhp.com/file%20library/file%20library/fee%20schedules.

Refer to: "Sterilization Consent Form (English)" and "Sterilization Consent Form (Spanish)".

"Sterilization Consent Form and Instructions" .

"Women's Health Program" for information on billing the Women's Health Program for sterilizations