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Update to TMPPM for Cytopathology Studies and Therapeutic Apheresis

Last updated on 4/26/2019

Beginning May 1, 2019, TMHP will update the Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook.

The changes are as follows:

  • The following benefit limitation statement will be added to section, “Cytopathology Studies—Other Than Gynecological”:

Procedure code 88177 is limited to three services per day by the same provider.

  • The following statement will be removed from section 9.2.72, “Therapeutic Apheresis” to align with current benefit limitations:

Apheresis services represents one 30-minute time interval of personal physician involvement in the apheresis. Apheresis is limited to three 30-minute time intervals per procedure. The actual time must be reflected on the claim, or a unit of 1, 2, or 3 must be indicated. If the time (or unit) is not indicated, payment is based on one 30-minute time interval.

For more information, call the TMHP Contact Center at 800-925-9126.