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December 2016 Texas Medicaid Provider Procedures Manual

Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook : 2 Medicaid Title XIX Family Planning Services : 2.2 Services, Benefits, Limitations, and Prior Authorization : 2.2.6 Drugs and Supplies : 2.2.6.4 Injection Administration

2.2.6.4
Injection administration billed by a provider is reimbursed separately from the medication. If billed without procedure code J1050 and modifier U1, procedure code 96372 must be billed with a family planning diagnosis and a description of the medication in the Remarks field of the claim. Injection administration is not payable to outpatient hospitals.
Refer to:
Subsection 2.2, “Services, Benefits, Limitations, and Prior Authorization” in this handbook for a list of family planning diagnosis codes.

Texas Medicaid & Healthcare Partnership
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