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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : Appendix C. Lead Screening : C.4 Environmental Lead Investigation Services : C.4.2 Services, Benefits, Limitations, and Prior Authorization

ELI services must be billed with procedure code T1029, which is restricted to the following diagnosis codes:
Texas Medicaid may only reimburse a state or local health department for the certified lead risk assessor’s time and activities during an onsite investigation of a client’s home or primary residence. Laboratory analysis of environmental substances (e.g., water, paint, or soil) is not a benefit of Texas Medicaid.
Children who have confirmed and persistent EBLLs may require an ELI to determine the source of the lead exposure. An ELI is completed in a client’s home or primary residence by a certified lead risk assessor to determine whether a lead hazard exists and, if so, whether the lead source could be the cause of the EBLL.

Texas Medicaid & Healthcare Partnership
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