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December 2016 Texas Medicaid Provider Procedures Manual

Ambulance ServicesHandbook : 2 Ambulance Services : 2.4 Claims Filing and Reimbursement : 2.4.2 Reimbursement

2.4.2
Ground and air ambulance providers are reimbursed based on the lesser of a provider’s billed charges or the maximum fee established by the Texas Health and Human Services Commission (HHSC) in accordance with 1 TAC §355.8600. Providers can refer to the Online Fee Lookup (OFL) or the applicable fee schedule on the TMHP website at www.tmhp.com.
Refer to:
Subsection 2.2, “Fee-for-Service Reimbursement Methodology” in Section 2, “Texas Medicaid Fee-for-Service Reimbursement” (Vol. 1, General Information) for more information about reimbursement methodologies.
Subsection 1.11, “Texas Medicaid Limitations and Exclusions” in Section 1, “Provider Enrollment and Responsibilities” (Vol. 1, General Information) for information on Medicaid exclusions.

Texas Medicaid & Healthcare Partnership
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