TMPPM 2008 > Texas Medicaid Services > Tuberculosis (TB) Clinics > Reimbursement

44.3 Reimbursement

The Medicaid rates for TB clinics are calculated in accordance with 1 TAC §355.8341.

Chest X-rays are payable in addition to the encounter rate for TB clinic services because of the large variations in client needs and frequency of X-rays. The Medicaid rate for X-rays are calculated in accordance with 1 TAC §§355.8341 and 355.8085 and are listed in the current physician fee schedule, which is available on the TMHP website at www.tmhp.com/file library/file library/fee schedules. To request a hard copy, call the TMHP Contact Center at 1-800-925-9126.

Private providers of TB-related clinic services will receive the maximum allowable fee. Public providers of TB-related clinic services will only receive the federal matching rate of the maximum allowable fee in effect at the time of service. The federal matching rate is adjusted on October 1 of each year, or as otherwise directed by the Centers for Medicare & Medicaid Services (CMS).

Public providers of TB-related clinic services receive only the federal share of Medicaid payments. The nonfederal share of the Medicaid payments to public provider TB clinics are funded through certification of public expenditures (CPE). DSHS will certify for those public provider TB clinics that have a contract with IDCU/TB.

Refer to: "Reimbursement" for more information.