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Update to “Coronavirus Testing Procedure Codes to Become a Benefit”

Last updated on 6/4/2020

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.

This is an update to the article titled "Coronavirus Testing Procedure Codes to Become a Benefit," which was published on this website March 16, 2020.

The article stated procedure code U0002 is a benefit of Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program for dates of service on or after February 4, 2020.

The Centers for Medicare & Medicaid Services (CMS) has categorized procedure code U0002 as a Clinical Laboratory Improvement Amendments (CLIA) waived test.

Effective for dates of service on or after March 20, 2020, procedure code U0002 must be submitted with modifier QW.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.