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Fee Schedules for COVID-19 Services Removed

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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.

The Texas Medicaid fee schedule information for COVID-19 services has been removed from the static fee schedules.

COVID-19 services will remain covered by Texas Medicaid and continue to be located within the appropriate static fee schedule on the Online Fee Lookup (OFL). The most common static fee schedules where COVID-19 procedure codes can be found are listed in the following spreadsheet:

List of Fee Schedules for COVID-19 Procedure Codes

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