TMPPM 2010 > Volume 1, General Information > Section 6: Claims Filing > Claims Filing Instructions > Claim Form Requirements > Prior Authorization Numbers on Claims Prior Authorization Numbers on Claims

Claims filed to TMHP must contain only one prior authorization number per claim. Prior authorization numbers must be indicated on the appropriate electronic field, or on the paper claim forms as indicated below:

CMS-1500-Block 23

UB-04 CMS-1450-Block 63

ADA-Block 2

Family Planning-Block 30

Texas Medicaid & Healthcare Partnership
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