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December 2016 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 5 STAR+PLUS Program : 5.3 STAR+PLUS Program Benefits : 5.3.4 Behavioral Health Billing

Behavioral health claims for services rendered to STAR+PLUS clients residing in ICF-IIDs or nursing facilities in the Dallas SA must be submitted to TMHP and processed through Medicaid FFS.
Behavioral health claims for Dallas SA nursing facility residents who are dual eligible for Medicare and Medicaid must continue to be submitted to Medicare first. Medicaid will continue to reimburse providers for the appropriate cost-sharing liabilities.

Texas Medicaid & Healthcare Partnership
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