TMPPM 2008 > Texas Medicaid Services > Radiological and Physiological Laboratory and Portable X-Ray Supplier > Benefits and Limitations

39.3.7 Diagnosis Requirements for Other Services

A diagnosis is not required with a provider's request for payment except when providing the following services: A/EEGs, arteriograms, cardiac blood pool imaging, chest X-rays, CT scans, echography, electrocardiograms (ECGs), MRAs, MRIs, mammographies, noninvasive diagnostic studies, polysomnographies, and venographies.

Claims for all services provided to clients eligible for "Emergency Care Only" must have a diagnosis to be considered for reimbursement. As with all procedures billed to the Texas Medicaid Program, most baseline screening or comparison studies are not a benefit.

Refer to: "Physician" for more information about these services.