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2012 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 5. NorthSTAR Program : 5.3 NorthSTAR Program Benefits : 5.3.1 Hospital Billing

5.3.1
Hospital Billing
In the Dallas SA, SSI clients are subject to mandatory enrollment in Medicaid managed care through the NorthSTAR Program. In some instances, general acute care hospitals treat a NorthSTAR client with a primary behavioral health diagnosis. In that instance, the general acute care hospital needs to seek authorization and reimbursement from ValueOptions using the CMS‑1500 form for outpatient services and UB-04 CMS-1450 for inpatient services.

Texas Medicaid & Healthcare Partnership
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