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Information posted April 1, 2020
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.
Case management may be delivered through synchronous audio-visual technologies or telephone (audio-only). Providers should bill procedure code T1017 using the 95 modifier to indicate that remote delivery occurred.
This direction applies to the following services:
- Mental Health Targeted Case Management (MHTCM)
- Intellectual or developmental disability (IDD) case management
- Targeted Case Management for Early Childhood Intervention (ECI)
- Case Management for Blind and Visually Impaired Children (BVIC)
- Case Management for Children and Pregnant Women (CPW)
More information for providers related to COVID-19 can be found here.
For more information, call the TMHP Contact Center at 800-925-9126.