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December 2016 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 8 Children’s Medicaid Dental Services : 8.7 Children’s Medicaid Dental Orthodontia Services

The Medicaid managed care dental plans will be responsible for prior authorizing, processing, and reimbursing any orthodontic services rendered to Texas Medicaid fee-for-service and managed care clients. Claims for orthodontic services that were initially authorized by TMHP but later transitioned to a managed care dental plan will be processed and reimbursed by the dental plan. Providers should check client eligibility to identify the managed care dental plan in which the client is enrolled.
TMHP will continue to processes claims and claims adjustments for:

Texas Medicaid & Healthcare Partnership
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