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2012 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 2. Medicaid Children’s Services Comprehensive Care Program (CCP) : 2.8 Personal Care Services (PCS) (CCP) : 2.8.4 Claims Information

Claims Information
TMHP processes PCS claims. PCS providers must submit claims for services in an approved electronic claims format or on the appropriate claim form based on their provider type. Providers, other than home health agencies, enrolled as a PAS-only provider, a CDSA, or an SRO provider must file PCS claims using CMS‑1500 paper claim form. Home health agencies, including those enrolled as a CDSA, or an SRO provider, must file PCS claims using the UB‑04 CMS‑1450 paper claim form. TMHP does not supply the forms.
Home health agencies and consumer-directed agencies that bill for PCS using procedure code T1019 must include the prior authorization number on claims submitted for reimbursement. Additionally, providers utilizing paper, TexMedConnect, or billing through EDI must include the prior authorization number with all claims submissions.

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