Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.
Effective July 10, 2018, for dates of service on or after July 1, 2018, benefit criteria for procedure code A6250 billed without a modifier will change for Texas Medicaid.
The following are benefit changes for skin sealants, protectants, moisturizers, and ointments procedure code A6250 without a modifier:
- Will no longer be limited to two services per month
- Will require prior authorization for clients up to three years old
This article updates the article titled “Wound Care Equipment and Supply Benefits to Change for Texas Medicaid July 1, 2018,” which was published on this website June 22, 2018.
For more information, call the TMHP Contact Center at 800-925-9126.