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 April 1, 2020, for dates of service on or after February 4, 2020, the reimbursement rates for coronavirus testing procedure codes U0001 and U0002 were implemented.
The following link shows the updates:
Affected claims with dates of service from February 4, 2020, through April 1, 2020, if any are identified, will be reprocessed. Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete.
For more information:
- Refer to the Health and Human Services Rate Analysis web page at hhs.texas.gov/rate-packets.
Call the TMHP Contact Center at 800-925-9126.