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Additional Second Quarter 2024 HCPCS Updates

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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.

On July 12, 2024, the Centers for Medicare and Medicaid Services (CMS) released revised second quarter 2024 Healthcare Common Procedure Coding System (HCPCS) files, resulting in additional updates.

Updates for Added Procedure Codes

The description for previously added procedure code A9506 has been revised.

Effective July 2, 2024, procedure code J0175 has been added as a noncovered procedure code for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program.

Updates for Discontinued Procedure Codes

CMS discontinued procedure codes C9787 and C9790.

Update for Informational Procedure Codes

Procedure code 0020M has been added as informational only.

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