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December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 3 Case Management for Children and Pregnant Women : 3.6 Claims Filing and Reimbursement : 3.6.2 Managed Care Clients

3.6.2
Case Management for Children and Pregnant Women services are carved out of Medicaid managed care and must be billed to TMHP for payment consideration. Carved-out services are those that are rendered to Medicaid managed care clients, but are administered by TMHP and not the client’s managed care organization (MCO).

Texas Medicaid & Healthcare Partnership
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