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Reimbursement Rates for the 2020 HCPCS Procedure Codes Implemented for the CSHCN Services Program

Last updated on 5/18/2020

Effective April 23, 2020, for dates of service on or after January 1, 2020, reimbursement rates for some 2020 Healthcare Common Procedure Coding System (HCPCS) procedure codes were implemented for the Children with Special Health Care Needs (CSHCN) Services Program.

Effective for dates of service on or after January 1, 2020

The annual HCPCS procedure codes that were implemented are listed in the following tables:

  • Ambulatory Surgical Centers/Hospital Ambulatory Surgical Centers
  • Blood Products
  • Clinical Diagnostic Laboratory Services
  • Dental
  • Drugs
  • Hospital Diagnostic Imaging Table 1
  • Rural Hospital Diagnostic Imaging Table 2
  • Non-Drugs
  • Nonclinical Laboratory Services
  • Radiology Services
  • Surgery and Assistant Surgery

TMHP will automatically reprocess affected claims, if any are identified; providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete.

For more information, call the TMHP-CSHCN Services Program Contact Center at 800-568-2413.

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