On March 28, 2019, TMHP implemented the first quarter 2019 Healthcare Common Procedure Coding System (HCPCS) additions, revisions, and discontinuations, which will be effective for dates of service on or after April 1, 2019. The HCPCS updates are detailed in this article.
First Quarter 2019 HCPCS Added Procedure Codes
Effective April 1, 2019, 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 CSHCN adopts the rates. 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 were 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.
First Quarter 2019 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.