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December 2016 Texas Medicaid Provider Procedures Manual

Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook : 7 Maternity Service Clinics (MSC) : 7.2 Services, Benefits, Limitations, and Prior Authorization : 7.2.1 Initial Prenatal Care Visit Components : Laboratory Tests
The initial hematocrit or hemoglobin and each subsequent hematocrit or hemoglobin is included in the visit fee and is not separately reimbursable to MSCs.
The laboratory services listed may not be billed using the MSC provider identifier. These services may be ordered by MSC personnel and provided by a reference laboratory.
MSCs must supply the client’s Medicaid number and the MSC provider identifier to the reference laboratory when laboratory services are requested.
The laboratory services requested by an MSC may include, but are not limited to, the following:
The following tests may be performed at the initial prenatal care visit, as indicated:
As stated in the Health and Safety Code §81.090, screening for Hepatitis B virus infection, HIV, and Syphilis must be performed at the initial prenatal care visit. In addition, HIV testing must be performed in the third trimester. HBV and Syphilis must be performed at labor and delivery.
Multiple marker screens for neural tube defects must be offered if the client initiates care between 16 and 20 weeks.

Texas Medicaid & Healthcare Partnership
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