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2012 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 4. Texas Health Steps (THSteps) Dental : 4.5 Claims Filing and Reimbursement

4.5 Claims Filing and Reimbursement
4.5.1
The Medicaid rates for dentists are calculated as access-based fees in accordance with 1 TAC §§355.8081, 355.8085, 355.8441(11), and 355.455(b). See the applicable fee schedule on the TMHP website at www.tmhp.com. To request a hard copy of the fee schedule, call the TMHP Contact Center at 1‑800‑925‑9126.
Effective for dates of service on or after September 1, 2010, Texas Medicaid implemented a 1-percent reduction in the final payment amounts for inpatient, professional, and outpatient services. TEFRA-reimbursed inpatient hospitals (children’s and state teaching hospitals) are excluded from the 1-percent reimbursement reduction.

Texas Medicaid & Healthcare Partnership
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