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December 2016 Texas Medicaid Provider Procedures Manual

Clinics and Other Outpatient Facility Services Handbook : 6 Renal Dialysis Facility : 6.5 Medicare and Medicaid : 6.5.2 Physician Providers

6.5.2
The five percent reduction does not apply to physician-billed services. Nephrologists that are enrolled in Texas Medicaid as physician providers may be reimbursed according to the current payment guidelines.
Refer to:
Subsection 2.7, “Medicare Crossover Claim Reimbursement” in Section 2, “Texas Medicaid Fee-for-Service Reimbursement” (Vol. I, General Information) for additional information about Medicare coinsurance and deductible reimbursement for professional and outpatient services.

Texas Medicaid & Healthcare Partnership
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