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Texas Medicaid Provider Homepage

This is the provider homepage for Texas Medicaid. The information on these pages help Medicaid providers succeed with their Medicaid practice. For information specific to a related program, click on the program's button above.

Below are links to the current news for Texas Medicaid providers. Click here to view past news articles.

News for Medicaid Providers

Benefits

Correction to “Benefit Updates for…Radiology Diagnostic Imaging Procedure Codes Effective August 2011” - 2/3/2012 New

New

Update to “Correction Concerning Family Counseling and Psychotherapy Procedure Code 90847” - 2/2/2012

Correction to “Clarification: Billing for Psychological and Neuropsychological Testing Services” - 1/31/2012

Update to the January 2012 HCPCS Special Bulletin, No. 4 - 1/27/2012

Place of Service Changes for Clinician-Directed Care Coordination Services – CCP - 1/27/2012

Procedure Code 21248 to Be a Benefit in the Office Setting - 1/26/2012

Correction to “Clarification of…Certified Nurse Midwives Must Submit Supervising Physician Information to TMHP” - 11/18/2011

Claims Reprocessing

Claims for Prior Authorized Radiological Services May Have Been Denied in Error - 1/23/2012

Code Updates

January 2012 First Quarter NCCI Updates - 1/30/2012

General

Correction to TMHP Medicaid Audit Department Phone Number - 2/3/2012 New

New

Follow-up to “Coming Soon: TexMedConnect and EDI to Accept Most Claim Submissions for Routing to Health and Dental Plans” - 1/30/2012

Correction: No Exemption for North Star HMO Providers From 24-Month Inactivity Requirement - 1/27/2012

HHSC Surveying Providers About DSH and UPL Programs - 1/23/2012

Women’s Health Program (WHP) Extended; Providers Can Still File Claims, Enroll, and Certify; New WHP Providers Needed - 1/23/2012

Reminder to Physician Assistant Providers About Performance of Elective Abortion - 10/28/2011

Hospital Initiatives

Texas Medicaid Transitioning to APR-DRG Inpatient Hospital Payment Structure Effective September 1, 2012 - 2/3/2012 New

New

Posting of PPR Reports Delayed - 1/24/2012

Managed Care

STAR and STAR+PLUS Medicaid Managed Care Expansion Town Hall Meeting Upcoming in Hidalgo Service Area - 2/1/2012

STAR and STAR+PLUS Providers Must Ensure OPL Information Is Current - 1/31/2012

Medicare Dual Eligibility

Changes to Medicare Crossover Claims Processing and Reimbursement Effective January 1, 2012 - 12/1/2011

NDC

Correction to “Valid NDC Codes Added Retroactively” - 2/3/2012 New

New

New Publications

Banner messages for 02/06/12 and 02/10/12 - 2/3/2012 New

New

March/April Medicaid Bulletin No. 240 - 1/30/2012

Banner messages for 01/30/12 and 02/03/12 - 1/27/2012

HCPCS Special Bulletin January 2012 - 12/30/2011

Reimbursement Rates

Correction to “Eight-Percent Rate Reduction to Be Eliminated for Inpatient Hospital Services to Most Medicaid Clients Effective March 1, 2012” - 2/2/2012

Reimbursement Rates for Some Independent Therapy, Home Health Agency Therapy, CORFs and ORFs Services to Change for Texas Medicaid March 1, 2012 - 1/31/2012

Eight-Percent Rate Reduction to Be Eliminated for Inpatient Hospital Services to Most Medicaid Clients Effective March 1, 2012 - 1/25/2012

Reminders

Reminder: Blood Pressure Devices and Prior Authorization - 1/27/2012

Reminder: Physicians Must Verify Medical Necessity Before Signing Certification Forms - 1/27/2012

Click here for information on changes to Wheeled Mobility Systems.

Changes to the Medicaid ID are here! Click here for information on the new Your Texas Benefits Medicaid card.

Topics: Information of interest to providers, including NDC and Alberto N. and past initiatives such as PACT transition and hurricanes

Health IT: How information technology can enhance health care. Click to learn more.

HHSC IMPROVE. Where Texas Medicaid providers can submit concerns and suggestions. Click here to go to site.

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