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2012 Texas Medicaid Provider Procedures Manual

Gynecological and Reproductive Health and Family Planning Services Handbook : 4. Department of State Health Services (DSHS) Family Planning Program Services : 4.2 Services, Benefits, Limitations, and Prior Authorization : 4.2.6 Drugs and Supplies

4.2.6
The following drug and supply procedure codes may be reimbursed as:
Procedure code J3490 may be reimbursed when a prescription medication to treat a genital infection is provided to the client. Procedure code A9150 may be reimbursed when a nonprescription medication to treat a monilia infection is provided to the client.

Texas Medicaid & Healthcare Partnership
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