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Update to “Reimbursement Rate Changes and Updates for Certain Texas Medicaid Procedure Codes Effective March 1, 2024”

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

This is an update to “Reimbursement Rate Changes and Updates for Certain Texas Medicaid Procedure Codes Effective March 1, 2024,” which was published on this website on January 22, 2024. The Physician Administered Drugs Non-Oncology spreadsheet linked in that article previously included some incorrect rates. The spreadsheet has now been updated to feature the correct procedure codes and reimbursement information.

To see the updates, view the Physician Administered Drugs Non-Oncology spreadsheet.

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