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Third Quarter 2018 HCPCS Updates for the CSHCN Services Program

Last updated on 9/28/2018

On September 27, 2018, TMHP implemented the third quarter 2018 Healthcare Common Procedure Coding System (HCPCS) additions, revisions, and discontinuations, which will be effective for dates of service on or after October 1, 2018. The HCPCS updates are detailed in this article.

Third Quarter 2018 HCPCS Added Procedure Codes

Effective October 1, 2018, the following procedure codes will be added as non-covered procedure codes for the Children with Special Health Care Needs (CSHCN) Services Program:

Procedure Codes
C9033 C9034 C9750 G9978 G9979 G9980
G9981 G9982 G9983 G9984 G9985 G9986
G9987 Q5108 Q5110      

New benefits adopted by Texas Medicaid must complete the rate hearing process to receive public comment on proposed Texas Medicaid reimbursement rates. The CSHCN Services Program reviews the adopted Texas Medicaid rates to determine whether the rates are fiscally feasible for the CSHCN Services Program.

After the rate hearing, expenditures must be approved before the rates are adopted by the CSHCN Services Program. Providers will be notified in a future banner message or notification if a proposed reimbursement rate will change or if a procedure code will not be reimbursed because the expenditures are not approved.

Providers may also refer to the following website for details related to rate hearings: www.hhs.texas.gov/about-hhs/communications-events/meetings-events

Third Quarter 2018 HCPCS Revised Procedure Codes

The description of the following procedure codes will be revised:

Procedure Codes
0006U K0037        

Third Quarter 2018 HCPCS Informational Procedure Codes

The following procedure codes will be added as informational only:

Procedure Codes
0045U 0046U 0047U 0048U 0049U 0050U
0051U 0052U 0053U 0054U 0055U 0056U
0057U 0058U 0059U 0060U 0061U  

For more information, call the TMHP-CSHCN Services Program Contact Center at 800-568-2413.