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 December 1, 2019, benefit information for pediatric hospital beds will be updated for clarification. Following is the updated information:
- Providers must use procedure code E1399 for reflux slings.
- A safety enclosure or enclosed bed may be considered through the Comprehensive Care Program for safety use.
For more information, call the TMHP Contact Center at 800-925-9126.