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December 2016 Texas Medicaid Provider Procedures Manual

Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook : 9 Physician : 9.2 Services, Benefits, Limitations, and Prior Authorization : 9.2.64 Renal Disease : Laboratory Services for Dialysis Patients
Texas Medicaid may reimburse for laboratory services performed for dialysis patients.
Charges for routine laboratory services performed according to established frequencies are included in the facility’s composite rate billed to Texas Medicaid regardless of where the tests were performed. Routine laboratory testing processed by an outside laboratory are billed to the facility and billed by a renal dialysis facility, unless they are inclusive tests.
Nonroutine laboratory services for people dialyzing in a facility and all laboratory work for people on CAPD may be billed separately from the dialysis charge.
Refer to:
Subsection 6.2.9, “Laboratory and Radiology Services,” in the Clinics and Other Outpatient Facility Services Handbook (Vol. 2, Provider Handbooks) for more information on laboratory services.

Texas Medicaid & Healthcare Partnership
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