Beginning May 1, 2019, the Children with Special Health Care Needs (CSHCN) Services Program Provider Manual, Physician chapter will be updated to include benefit limitation information for procedure codes 99251, 99252, 99253, 99254, and 99255.
The following statement will be added to section 184.108.40.206, “Consultations”:
One initial inpatient consultation (procedure code 99251, 99252, 99253, 99254, or 99255) is allowed for each hospitalization within a 30-day period. Subsequent consultations billed as initial consultations during this period will be denied.
For more information, call the TMHP-CSHCN Services Program Contact Center at 800-568-2413.