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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 4: Client Eligibility : 4.4 Restricted Medicaid Coverage : 4.4.2 Client Limited Program : 4.4.2.6 Referral to Other Providers

4.4.2.6
Referral to Other Providers
Texas Medicaid fee-for-service clients with a limited status may be referred by their designated provider to other providers. For the referred provider to be paid, the provider identifier of the referring designated provider must be in the referring provider field of the claim form. Claims submitted electronically (see subsection 6.2, “TMHP Electronic Claims Submission” in Section 6, “Claims Filing” [Volume 1, General Information]) must have the NPI of the referring designated provider in the Referring Provider Field. Providers must consult with their vendor for the location of this field in the electronic claims format.

Texas Medicaid & Healthcare Partnership
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