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2012 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 2. Medicaid Children’s Services Comprehensive Care Program (CCP) : 2.3 Comprehensive Outpatient Rehabilitation Facilities (CORFs)and Outpatient Rehabilitation Facilities (ORFs) : 2.3.6 Claims Information

2.3.6
Providers must submit services provided by CORFs and ORFs in an approved electronic claims format or on the UB-04 CMS-1450 paper claim form from the vendor of their choice. TMHP does not supply the forms.
Revenue and Current Procedural Terminology (CPT) procedure codes are used when submitting claims for CORF and ORF services. The only POS is outpatient facility (POS 5).
Refer to:
Section 3: TMHP Electronic Data Interchange (EDI) (Vol. 1, General Information) for information on electronic claims submissions.
Section 6: Claims Filing (Vol. 1, General Information) for general information about claims filing.
Subsection 6.6, “UB-04 CMS-1450 Paper Claim Filing Instructions” in Section 6, “Claims Filing” (Vol. 1, General Information) for paper claims completion instructions.

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