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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 2 Medicaid Children’s Services Comprehensive Care Program (CCP) : 2.11 Personal Care Services (PCS) (CCP) : 2.11.5 Claims Information : 2.11.5.1 Managed Care Clients

2.11.5.1
PCS services are carved-out of the Medicaid Managed Care Program for State of Texas Access Reform (STAR) clients 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 MCO. Claims for STAR Health and STAR+PLUS are not carved out and must be submitted to the client’s MCO for payment consideration.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.