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December 2016 Texas Medicaid Provider Procedures Manual

Women’s Health Services Handbook : 3 Health and Human Services Commission (HHSC) Family Planning Program Services : 3.2 Services, Benefits, Limitations, and Prior Authorization : 3.2.3 Laboratory Procedures

The following procedure codes may be reimbursed for HHSC Family Planning Program family planning laboratory services:
Appropriate documentation must be maintained in the client’s record.
Refer to:
Subsection 2.3.4, “* Laboratory Procedures” in this handbook for more information about family planning laboratory services requirements.
Subsection 2.1.1, “Clinical Laboratory Improvement Amendments (CLIA)” in the Radiology and Laboratory Services Handbook (Vol. 2, Provider Handbooks).
Texas Medicaid follows the Medicare categorization of tests for CLIA certificate holders.
Refer to:
The CMS website at for information about procedure code and modifier QW requirements.

Texas Medicaid & Healthcare Partnership
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