Table of Contents Previous Next Index

2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 6: Claims Filing : 6.13 Medicare Claims : 6.13.3 Medicare and Medicaid Assignment and Payments

6.13.3
Providers must accept Medicare assignment to receive Medicaid payment for any portion of the coinsurance and deductible amounts for services rendered to QMB and MQMB clients.
If a provider has accepted a Medicare assignment, the provider may receive, on behalf of the QMB or MQMB client, the lesser of the coinsurance and deductible payment, or the amount remaining after the Medicare payment amount is subtracted from the allowed Medicaid fee or encounter rate for the service.
Any payments made by Medicare and Medicaid must be considered payment in full. Providers that accept Medicare or Medicaid assignment cannot legally require the client to pay the Medicare coinsurance or deductible amounts or any remaining amount after Medicaid payment has been made.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2011 American Medical Association. All rights reserved.