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24.3.12 Evaluation and Management (E/M) Services
E/M services are benefits of the CSHCN Services Program. Medical documentation for E/M services must consist of the appropriate components (e.g., history, physical exam, medical decision making) as designated in the 1995 and 1997 Physician Evaluation and Management guidelines as published by the Centers for Medicare & Medicaid Services and CPT manual.
Covered professional services provided by physicians may be reimbursed the lower of the billed amount or the amount allowed by the Texas Medicaid Program. This manual may not list all E/M codes that may be reimbursed by the CSHCN Services Program.
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