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Updated Limitation for Zika Virus Testing Effective July 1, 2019

Last updated on 5/17/2019

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

Effective for dates of service on or after July 1, 2019, the limitation for Zika virus testing procedure code 87662 will change.

In an effort to align Zika virus testing reimbursement policy with updated Texas Department of State Health Services and U.S. Centers for Disease Control and Prevention guidelines, procedure code 87662 may be reimbursed up to two times on the same day by the same provider, and will no longer be limited to one per day.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.