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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 5 THSteps Medical : 5.5 Claims Filing and Reimbursement : 5.5.2 Reimbursement

5.5.2
As with all Medicaid services, providers acknowledge compliance with all Texas Medicaid requirements when they submit a claim for reimbursement. THSteps-enrolled providers are reimbursed for THSteps medical checkups and administration of immunizations in accordance with 1 TAC §355.8441.
Note:
NP, CNS, and PA providers who are enrolled in Texas Medicaid as THSteps providers may receive 92 percent of the rate paid to a physician for THSteps services.
FQHCs are reimbursed using visit rates calculated in accordance with 1 TAC §355.8261.
RHCs are reimbursed using visit rates calculated in accordance with 1 TAC §355.8101.
Providers may refer to the OFL or the applicable fee schedule on the TMHP website at www.tmhp.com.

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