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:
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:
Third Quarter 2018 HCPCS Informational Procedure Codes
The following procedure codes will be added as informational only:
For more information, call the TMHP-CSHCN Services Program Contact Center at 800-568-2413.