2010 Texas Medicaid Provider Procedures Manual

<h2 class="pTOCTitle">Table of Contents</h2> <p class="pTOC1"><a href="2010TMPPM-01-1.html" target="2010 TMPPM - website_frame">Volume 1, General Information</a></p> <p class="pTOC2"><a href="2010TMPPM-02-01.html" target="2010 TMPPM - website_frame">Front Matter</a></p> <p class="pTOC3"><a href="2010TMPPM-02-02.html" target="2010 TMPPM - website_frame">Welcome: 2010 Texas Medicaid Provider Procedures Manual</a></p> <p class="pTOC3"><a href="2010TMPPM-02-05.html" target="2010 TMPPM - website_frame">Contents</a></p> <p class="pTOC3"><a href="2010TMPPM-02-07.html" target="2010 TMPPM - website_frame">Introduction</a></p> <p class="pTOC3"><a href="2010TMPPM-02-09.html" target="2010 TMPPM - website_frame">TMHP Telephone and Address Guide</a></p> <p class="pTOC2"><a href="2010TMPPM-03-01.html" target="2010 TMPPM - website_frame">Section 1: Provider Enrollment and Responsibilities</a></p> <p class="pTOC2"><a href="2010TMPPM-04-01.html" target="2010 TMPPM - website_frame">Section 2: Texas Medicaid Reimbursement</a></p> <p class="pTOC2"><a href="2010TMPPM-05-01.html" target="2010 TMPPM - website_frame">Section 3: TMHP Electronic Data Interchange (EDI)</a></p> <p class="pTOC2"><a href="2010TMPPM-06-01.html" target="2010 TMPPM - website_frame">Section 4: Client Eligibility</a></p> <p class="pTOC2"><a href="2010TMPPM-07-01.html" target="2010 TMPPM - website_frame">Section 5: Prior Authorization</a></p> <p class="pTOC2"><a href="2010TMPPM-08-001.html" target="2010 TMPPM - website_frame">Section 6: Claims Filing</a></p> <p class="pTOC2"><a href="2010TMPPM-09-01.html" target="2010 TMPPM - website_frame">Section 7: Appeals</a></p> <p class="pTOC2"><a href="2010TMPPM-10-001.html" target="2010 TMPPM - website_frame">Section 8: Managed Care</a></p> <p class="pTOC2"><a href="2010TMPPM-11-1.html" target="2010 TMPPM - website_frame">Appendix A: State and Federal Offices Communication Guide</a></p> <p class="pTOC2"><a href="2010TMPPM-12-01.html" target="2010 TMPPM - website_frame">Appendix B: Vendor Drug Program</a></p> <p class="pTOC2"><a href="2010TMPPM-13-01.html" target="2010 TMPPM - website_frame">Appendix C: HIV/AIDS</a></p> <p class="pTOC2"><a href="2010TMPPM-14-1.html" target="2010 TMPPM - website_frame">Appendix D: Medical Transportation</a></p> <p class="pTOC2"><a href="2010TMPPM-15-1.html" target="2010 TMPPM - website_frame">Appendix E: Acronym Dictionary</a></p> <p class="pTOC1"><a href="2010TMPPM-16-1.html" target="2010 TMPPM - website_frame">Volume 2, Provider Handbooks</a></p> <p class="pTOC2"><a href="2010TMPPM-17-02.html" target="2010 TMPPM - website_frame">Ambulance Services Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-17-03.html" target="2010 TMPPM - website_frame">1. General Information</a></p> <p class="pTOC3"><a href="2010TMPPM-17-04.html" target="2010 TMPPM - website_frame">2. Ambulance Services</a></p> <p class="pTOC3"><a href="2010TMPPM-17-46.html" target="2010 TMPPM - website_frame">3. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-17-47.html" target="2010 TMPPM - website_frame">4. Claim Form Examples</a></p> <p class="pTOC2"><a href="2010TMPPM-18-002.html" target="2010 TMPPM - website_frame">Behavioral Health, Rehabilitation, and Case Management Services Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-18-003.html" target="2010 TMPPM - website_frame">1. General Information</a></p> <p class="pTOC3"><a href="2010TMPPM-18-004.html" target="2010 TMPPM - website_frame">2. Blind Children's Vocational Discovery and Development Program (BCVDDP)</a></p> <p class="pTOC3"><a href="2010TMPPM-18-010.html" target="2010 TMPPM - website_frame">3. Case Management for Children and Pregnant Women (CPW)</a></p> <p class="pTOC3"><a href="2010TMPPM-18-022.html" target="2010 TMPPM - website_frame">4. Early Childhood Intervention (ECI) Targeted Case Management Services</a></p> <p class="pTOC3"><a href="2010TMPPM-18-030.html" target="2010 TMPPM - website_frame">5. Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), and Licensed Professional Counselor (LPC)</a></p> <p class="pTOC3"><a href="2010TMPPM-18-046.html" target="2010 TMPPM - website_frame">6. Mental Health Rehabilitation, Mental Health Case Management, and Mental Retardation Service Coordination</a></p> <p class="pTOC3"><a href="2010TMPPM-18-055.html" target="2010 TMPPM - website_frame">7. Physician, Psychologist, and Licensed Psychological Associate (LPA) Providers</a></p> <p class="pTOC3"><a href="2010TMPPM-18-104.html" target="2010 TMPPM - website_frame">8. Screening, Brief Intervention, and Referral to Treatment (SBIRT)</a></p> <p class="pTOC3"><a href="2010TMPPM-18-112.html" target="2010 TMPPM - website_frame">9. Claims Resources</a></p> <p class="pTOC3"><a href="2010TMPPM-18-113.html" target="2010 TMPPM - website_frame">10. Contact TMHP</a></p> <p class="pTOC3"><a href="2010TMPPM-18-114.html" target="2010 TMPPM - website_frame">11. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-18-115.html#wp1864125" target="2010 TMPPM - website_frame">12. Claim Form Examples</a></p> <p class="pTOC2"><a href="2010TMPPM-19-002.html" target="2010 TMPPM - website_frame">Children's Services Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-19-003.html" target="2010 TMPPM - website_frame">1. General Information</a></p> <p class="pTOC3"><a href="2010TMPPM-19-005.html" target="2010 TMPPM - website_frame">2. Chemical Dependency Treatment Facility Services</a></p> <p class="pTOC3"><a href="2010TMPPM-19-012.html" target="2010 TMPPM - website_frame">3. Medicaid Children's Services (CCP)</a></p> <p class="pTOC3"><a href="2010TMPPM-19-199.html" target="2010 TMPPM - website_frame">4. School Health and Related Services (SHARS)</a></p> <p class="pTOC3"><a href="2010TMPPM-19-239.html" target="2010 TMPPM - website_frame">5. Texas Health Steps (THSteps) Dental</a></p> <p class="pTOC3"><a href="2010TMPPM-19-305.html" target="2010 TMPPM - website_frame">6. THSteps Medical</a></p> <p class="pTOC3"><a href="2010TMPPM-19-356.html" target="2010 TMPPM - website_frame">7. Claims Resources</a></p> <p class="pTOC3"><a href="2010TMPPM-19-357.html" target="2010 TMPPM - website_frame">8. Contact TMHP</a></p> <p class="pTOC3"><a href="2010TMPPM-19-364.html" target="2010 TMPPM - website_frame">9. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-19-383.html" target="2010 TMPPM - website_frame">10. Claim Form Examples</a></p> <p class="pTOC3"><a href="2010TMPPM-19-398.html" target="2010 TMPPM - website_frame">11. Appendices</a></p> <p class="pTOC2"><a href="2010TMPPM-20-01.html" target="2010 TMPPM - website_frame">Appendix A: THSteps Forms</a></p> <p class="pTOC2"><a href="2010TMPPM-21-01.html" target="2010 TMPPM - website_frame">Appendix B: Immunizations</a></p> <p class="pTOC2"><a href="2010TMPPM-22-1.html" target="2010 TMPPM - website_frame">Appendix C: Lead Screening</a></p> <p class="pTOC2"><a href="2010TMPPM-23-01.html" target="2010 TMPPM - website_frame">Appendix D: Texas Health Steps Statutory State Requirements</a></p> <p class="pTOC2"><a href="2010TMPPM-24-1.html" target="2010 TMPPM - website_frame">Appendix E: Hearing Screening Information</a></p> <p class="pTOC2"><a href="2010TMPPM-25-1.html" target="2010 TMPPM - website_frame">Appendix F: THSteps Quick Reference Guide</a></p> <p class="pTOC2"><a href="2010TMPPM-26-1.html" target="2010 TMPPM - website_frame">Appendix G: THSteps Dental Guidelines</a></p> <p class="pTOC2"><a href="2010TMPPM-27-002.html" target="2010 TMPPM - website_frame">Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-27-003.html" target="2010 TMPPM - website_frame">1. Texas Medicaid (Title XIX) Home Health Services</a></p> <p class="pTOC3"><a href="2010TMPPM-27-235.html" target="2010 TMPPM - website_frame">2. Claims Resources</a></p> <p class="pTOC3"><a href="2010TMPPM-27-236.html" target="2010 TMPPM - website_frame">3. Contact TMHP</a></p> <p class="pTOC3"><a href="2010TMPPM-27-237.html" target="2010 TMPPM - website_frame">4. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-27-253.html" target="2010 TMPPM - website_frame">5. Claim Form Examples</a></p> <p class="pTOC2"><a href="2010TMPPM-28-002.html" target="2010 TMPPM - website_frame">Gynecological and Reproductive Health, Obstetrics, and Family Planning Services Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-28-003.html" target="2010 TMPPM - website_frame">1. General Information</a></p> <p class="pTOC3"><a href="2010TMPPM-28-004.html" target="2010 TMPPM - website_frame">2. Certified Nurse Midwives</a></p> <p class="pTOC3"><a href="2010TMPPM-28-014.html" target="2010 TMPPM - website_frame">3. Medicaid Title XIX family planning services</a></p> <p class="pTOC3"><a href="2010TMPPM-28-051.html" target="2010 TMPPM - website_frame">4. Women's Health Program (Title XIX Family Planning)</a></p> <p class="pTOC3"><a href="2010TMPPM-28-081.html" target="2010 TMPPM - website_frame">5. Titles V, X, and XX Family Planning Services</a></p> <p class="pTOC3"><a href="2010TMPPM-28-116.html" target="2010 TMPPM - website_frame">6. Maternity Service cLinics</a></p> <p class="pTOC3"><a href="2010TMPPM-28-134.html" target="2010 TMPPM - website_frame">7. Gynecological Health Services</a></p> <p class="pTOC3"><a href="2010TMPPM-28-147.html" target="2010 TMPPM - website_frame">8. Claims Resources</a></p> <p class="pTOC3"><a href="2010TMPPM-28-148.html" target="2010 TMPPM - website_frame">9. Contact TMHP</a></p> <p class="pTOC3"><a href="2010TMPPM-28-149.html" target="2010 TMPPM - website_frame">10. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-28-158.html" target="2010 TMPPM - website_frame">11. Claim Form Examples</a></p> <p class="pTOC2"><a href="2010TMPPM-29-002.html" target="2010 TMPPM - website_frame">Hospital Services Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-29-003.html" target="2010 TMPPM - website_frame">1. General Information</a></p> <p class="pTOC3"><a href="2010TMPPM-29-005.html" target="2010 TMPPM - website_frame">2. Hospital (Medical/Surgical Acute Care Facility)</a></p> <p class="pTOC3"><a href="2010TMPPM-29-101.html" target="2010 TMPPM - website_frame">3. Military Hospitals</a></p> <p class="pTOC3"><a href="2010TMPPM-29-108.html" target="2010 TMPPM - website_frame">4. Claims Resources</a></p> <p class="pTOC3"><a href="2010TMPPM-29-109.html" target="2010 TMPPM - website_frame">5. Contact TMHP</a></p> <p class="pTOC3"><a href="2010TMPPM-29-110.html" target="2010 TMPPM - website_frame">6. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-29-118.html" target="2010 TMPPM - website_frame">7. Claim Form Examples</a></p> <p class="pTOC2"><a href="2010TMPPM-30-002.html" target="2010 TMPPM - website_frame">Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-30-003.html" target="2010 TMPPM - website_frame">1. General Information</a></p> <p class="pTOC3"><a href="2010TMPPM-30-004.html" target="2010 TMPPM - website_frame">2. Chiropractic Manipulative Treatment (CMT)</a></p> <p class="pTOC3"><a href="2010TMPPM-30-010.html" target="2010 TMPPM - website_frame">3. Certified Registered Nurse Anesthetist (CRNA)</a></p> <p class="pTOC3"><a href="2010TMPPM-30-019.html" target="2010 TMPPM - website_frame">4. Genetic Services</a></p> <p class="pTOC3"><a href="2010TMPPM-30-028.html" target="2010 TMPPM - website_frame">5. Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS)</a></p> <p class="pTOC3"><a href="2010TMPPM-30-036.html" target="2010 TMPPM - website_frame">6. Physician</a></p> <p class="pTOC3"><a href="2010TMPPM-30-382.html" target="2010 TMPPM - website_frame">7. Physician Assistant</a></p> <p class="pTOC3"><a href="2010TMPPM-30-388.html" target="2010 TMPPM - website_frame">8. Claims Resources</a></p> <p class="pTOC3"><a href="2010TMPPM-30-389.html" target="2010 TMPPM - website_frame">9. Contact TMHP</a></p> <p class="pTOC3"><a href="2010TMPPM-30-390.html" target="2010 TMPPM - website_frame">10. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-30-405.html" target="2010 TMPPM - website_frame">11. Claim Form Examples</a></p> <p class="pTOC2"><a href="2010TMPPM-31-02.html" target="2010 TMPPM - website_frame">Nursing and Therapy Services Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-31-03.html" target="2010 TMPPM - website_frame">1. General Information</a></p> <p class="pTOC3"><a href="2010TMPPM-31-04.html" target="2010 TMPPM - website_frame">2. Certified Respiratory Care Practitioner (CRCP) Services</a></p> <p class="pTOC3"><a href="2010TMPPM-31-11.html" target="2010 TMPPM - website_frame">3. Home Health Services For Nursing and Therapy</a></p> <p class="pTOC3"><a href="2010TMPPM-31-55.html" target="2010 TMPPM - website_frame">4. Personal Care Services (PCS)</a></p> <p class="pTOC3"><a href="2010TMPPM-31-56.html" target="2010 TMPPM - website_frame">5. Therapists, Independent Practitioners, and Physicians</a></p> <p class="pTOC3"><a href="2010TMPPM-31-67.html" target="2010 TMPPM - website_frame">6. Private Duty Nursing</a></p> <p class="pTOC3"><a href="2010TMPPM-31-68.html" target="2010 TMPPM - website_frame">7. Claims Resources</a></p> <p class="pTOC3"><a href="2010TMPPM-31-69.html" target="2010 TMPPM - website_frame">8. Contact TMHP</a></p> <p class="pTOC3"><a href="2010TMPPM-31-70.html" target="2010 TMPPM - website_frame">9. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-31-75.html" target="2010 TMPPM - website_frame">10. Claim Form Examples</a></p> <p class="pTOC2"><a href="2010TMPPM-32-02.html" target="2010 TMPPM - website_frame">Outpatient Services Handbook</a></p> <p class="pTOC2"><a href="2010TMPPM-32-03.html" target="2010 TMPPM - website_frame">Outpatient Services Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-32-03.html#wp1944432" target="2010 TMPPM - website_frame">1. General Information</a></p> <p class="pTOC3"><a href="2010TMPPM-32-05.html" target="2010 TMPPM - website_frame">2. Ambulatory Surgical Center and Hospital Ambulatory Surgical Center</a></p> <p class="pTOC3"><a href="2010TMPPM-32-17.html" target="2010 TMPPM - website_frame">3. Federally Qualified Health Center</a></p> <p class="pTOC3"><a href="2010TMPPM-32-28.html" target="2010 TMPPM - website_frame">4. Renal Dialysis Facility</a></p> <p class="pTOC3"><a href="2010TMPPM-32-48.html" target="2010 TMPPM - website_frame">5. Rural Health Clinic</a></p> <p class="pTOC3"><a href="2010TMPPM-32-61.html" target="2010 TMPPM - website_frame">6. Tuberculosis Clinics</a></p> <p class="pTOC3"><a href="2010TMPPM-32-74.html" target="2010 TMPPM - website_frame">7. Claims Resources</a></p> <p class="pTOC3"><a href="2010TMPPM-32-75.html" target="2010 TMPPM - website_frame">8. Contact TMHP</a></p> <p class="pTOC3"><a href="2010TMPPM-32-76.html" target="2010 TMPPM - website_frame">9. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-32-78.html" target="2010 TMPPM - website_frame">10. Claim Form Examples</a></p> <p class="pTOC2"><a href="2010TMPPM-33-02.html" target="2010 TMPPM - website_frame">Radiology, Laboratory, and PhysiologicAL Lab Services Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-33-03.html" target="2010 TMPPM - website_frame">1. General Information</a></p> <p class="pTOC3"><a href="2010TMPPM-33-04.html" target="2010 TMPPM - website_frame">2. Independent Laboratory</a></p> <p class="pTOC3"><a href="2010TMPPM-33-26.html" target="2010 TMPPM - website_frame">3. Physician-performed Radiology Services</a></p> <p class="pTOC3"><a href="2010TMPPM-33-27.html" target="2010 TMPPM - website_frame">4. Radiology, Physiological Laboratory, and Portable X-Ray Supplier</a></p> <p class="pTOC3"><a href="2010TMPPM-33-51.html" target="2010 TMPPM - website_frame">5. Claims Resources</a></p> <p class="pTOC3"><a href="2010TMPPM-33-52.html" target="2010 TMPPM - website_frame">6. Contact TMHP</a></p> <p class="pTOC3"><a href="2010TMPPM-33-53.html" target="2010 TMPPM - website_frame">7. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-33-54.html" target="2010 TMPPM - website_frame">8. Claim Form Examples</a></p> <p class="pTOC2"><a href="2010TMPPM-34-02.html" target="2010 TMPPM - website_frame">Vision and Hearing Services Handbook</a></p> <p class="pTOC3"><a href="2010TMPPM-34-03.html" target="2010 TMPPM - website_frame">1. General Information</a></p> <p class="pTOC3"><a href="2010TMPPM-34-04.html" target="2010 TMPPM - website_frame">2. Hearing Aid Professionals</a></p> <p class="pTOC3"><a href="2010TMPPM-34-40.html" target="2010 TMPPM - website_frame">3. Vision Care Professionals</a></p> <p class="pTOC3"><a href="2010TMPPM-34-81.html" target="2010 TMPPM - website_frame">4. Claims Resources</a></p> <p class="pTOC3"><a href="2010TMPPM-34-82.html" target="2010 TMPPM - website_frame">5. Contact TMHP</a></p> <p class="pTOC3"><a href="2010TMPPM-34-83.html" target="2010 TMPPM - website_frame">6. Forms</a></p> <p class="pTOC3"><a href="2010TMPPM-34-87.html" target="2010 TMPPM - website_frame">7. Claim Form Examples</a></p>