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.
This is a correction to the article titled “Reimbursement Rate Changes Presented at Public Rate Hearing on January 28, 2020, to Be Effective January 1, 2020” that was published on this website on March 9, 2020.
The Non-Drugs table listed in the article listed some procedure codes with an incorrect age range.
The table linked below reflects the correct reimbursement rates:
For more information, providers may refer to the HHSC Rate Analysis web page at rad.hhs.texas.gov/rate-packets.
For more information, call the TMHP Contact Center at 800-925-9126.