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2012 Texas Medicaid Provider Procedures Manual

Gynecological and Reproductive Health and Family Planning Services Handbook : 2. Medicaid Title XIX family planning services : 2.2 Services, Benefits, Limitations, and Prior Authorization : 2.2.3 Laboratory Procedures : 2.2.3.3 Lab Specimen Handling and Testing

2.2.3.3
Any test specimen sent to a laboratory may be reimbursed to the laboratory who performs the test and not to the referring family planning provider.
If the provider who obtains the specimen does not perform the laboratory procedure, the provider who obtains the specimen may be reimbursed one lab handling fee per day, per client, for the handling or conveyance of the specimen from the provider’s office to a laboratory using procedure code 99000 and a family planning diagnosis code. More than one lab handling fee may be reimbursed per day if multiple specimens are obtained and sent to different laboratories.
Handling fees are not paid for Pap smears or cultures. The appropriate procedure code may be reimbursed for Pap smear interpretations when billed with modifier SU in the office setting indicating that the screening and interpretation were actually performed in the office.

Texas Medicaid & Healthcare Partnership
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