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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 6: Claims Filing : 6.4 Claims Filing Instructions : 6.4.2 Claim Form Requirements : 6.4.2.7 Clients with a Designated or Primary Care Provider

6.4.2.7
Clients with a Designated or Primary Care Provider
Claims for clients with a primary care provider or designated provider (i.e., Texas Medicaid fee-for-service clients enrolled as Limited Program clients) must indicate the primary care provider or designated provider identifiers in the billing or performing provider fields.
When clients receive services from a different provider, such as a specialist, the primary care provider or designated provider's information must be included in the referring provider fields on the claim.

Texas Medicaid & Healthcare Partnership
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