This article has been updated. Click here to see the updates.
Information posted April 24, 2020
Note: Texas Medicaid managed care organizations 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.
As part of its continued response to COVID-19 (coronavirus), HHSC will provide Medicaid reimbursement for previously identified telemedicine and telehealth services for March 15, 2020 to May 31, 2020 dates of service.
The telemedicine and telehealth services include those listed in the following provider notifications:
- Claims for Telehealth Service for Occupational, Physical, and Speech Therapy
- SHARS Services Provided Through Telemedicine or Telehealth
- Clarification to ‘COVID-19 Guidance: Targeted Case Management Through Remote Delivery'
- RHC Reimbursement for Telemedicine and Telehealth Services
- Claims for Telephone (Audio Only) Medical Services
- Claims for Telephone (Audio Only) Behavioral Health Services
- FQHC Reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician-Delivered) Services
All services listed in the Texas Medicaid Provider Procedures Manual, Telecommunication Services Handbook continue to remain eligible for Medicaid reimbursement. Providers can refer to this handbook for additional information about the Texas Medicaid telemedicine and telehealth service benefits.
For more information, call the TMHP Contact Center at 1-800-925-9126.