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2012 Texas Medicaid Provider Procedures Manual

Clinics and Other Outpatient Facility Services Handbook : 8. Tuberculosis Services : 8.2 Services, Benefits, Limitations, and Prior Authorization : 8.2.2 Ancillary Services

8.2.2
The following ancillary TB services are a benefit of Texas Medicaid:
Certain injectable TB medications (procedure codes J2020, J2280, and J3000), which also have an oral formulation, must be billed with modifier KX to indicate that the oral formulation is not appropriate for the client.
All drugs for which Medicaid is billed must have been purchased by the TB clinic. In the event that the clinic received the drug at no cost through DSHS or another source, it cannot be billed to Texas Medicaid. All medication claims are subject to retrospective review.
Handling or conveyance of a specimen from the patient in the clinic to a laboratory (procedure code 99001) will be reimbursed only when submitted with one of the following professional or nursing services performed on the same date of service.

Texas Medicaid & Healthcare Partnership
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