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Procedure Codes Addition and Update for Coronavirus for the CSHCN Services Program

Last updated on 9/30/2020

Effective October 1, 2020, for dates of service on or after March 1, 2020, April 1, 2020, and June 25, 2020, COVID-19 telephonic and testing procedure codes 99441, 99442, 99443, and 87426 will become a benefit for the Children with Special Health Care Needs (CSHCN) Services Program, and procedure code 99001 for specimen collection services will be expanded.

Procedure Codes 99441, 99442, 99443 Addition

Effective for dates of service on or after March 1, 2020, COVID-19 telephonic procedure codes 99441, 99442, and 99443 will become a benefit for CSHCN Services Program. Click to view this table for more information.

Affected claims with dates of service on or after March 1, 2020, will be reprocessed and providers may receive an additional payment. Additional payments will be reflected on future Remittance and Status (R&S) Reports.

Note: Providers are not required to appeal the claims unless they are denied for other reasons after the claims reprocessing is complete.

Procedure Codes 87426 Addition

Effective for dates of service on or after June 25, 2020, procedure code 87426 for COVID 19 (coronavirus) testing will become a benefit for CSHCN Services Program. Click to view this table for more information.

Affected claims with dates of service on or after March 1, 2020, will be reprocessed and providers may receive an additional payment. Additional payments will be reflected on future Remittance and Status (R&S) Reports.

Note: Providers are not required to appeal the claims unless they are denied for other reasons after the claims reprocessing is complete.

Procedure Code 99001 Update

Effective for dates of service on or after April 1, 2020, the following place of service and provider types will be updated for procedure code 99001 for specimen collection services. Click to view this table for more information.

Affected claims with dates of service on or after April 1, 2020, will be reprocessed and providers may receive an additional payment. Additional payments will be reflected on future Remittance and Status (R&S) Reports.

Note: Providers are not required to appeal the claims unless they are denied for other reasons after the claims reprocessing is complete.

For more information, call the TMHP Contact Center at 800-925-9126.