Information posted June 26, 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.
Beginning July 1, 2020, TMHP will update the Texas Medicaid Provider Procedures Manual, Radiology and Laboratory Services Handbook, section 2.2.13, “Microbiology,” to add missing microbiology and molecular testing procedure codes to the table in the section. The reimbursable procedure codes added to the tables below are currently benefits and were omitted in error.
The following procedure codes will be added:
For more information, call the TMHP Contact Center at 800-925-9126.