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2020 TMPPM Release Notes

Last updated on 11/30/2020

The following tables show the section and handbooks that were changed in the Texas Medicaid Provider Procedures Manual. The changes are listed in reverse chronological order (newest first).

For changes that were made in 2019, see the 2019 Release Notes.

December 2020 Release Notes
Handbook	Related Articles and Notes
Volume 1: Appendix C: Acronym Dictionary	Added acronym for Family Planning Program and removed Women's Health Program to align with updates for Healthy Texas Women program.
Volume 1: Preliminary Information	Revised the list of provider manual handbooks to align with the Women's Health Services handbook name change and the new HHSC Family Planning Program Handbook.
Volume 1: Section 1: Provider Enrollment and Responsibilities	Revised the order for "Waste, Abuse, and Fraud" to "Fraud, Waste and Abuse," to align with the HHSC website language.
Volume 1: Section 4: Client Eligibility	Revised language and reference in section 4.7, "Healthy Texas Women (HTW) Program" section.
Behavioral Health and Case Management Services Handbook	References to the Medicaid client, individual, or recipient, have been changed to ‘person(s)’ or ‘person(s) receiving services’ as appropriate, throughout the Behavioral Health Services Handbook. Updated statements in sections 9.11.1, "Withdrawal Management Services," and 9.11.1.1, "Treatment Services," to add the word "lead."
Children’s Services Handbook: Medical services (Sections 1-3 and 5-9)	Updated title and removed "s" from Services to read as "Place of Service." Removed dental limitation statements from section 4.2.3.9, Therapeutic Services.
Clinics and Other Outpatient Facility Services Handbook	Revised Women's Health Services Handbook name references as Healthy Texas Women (HTW) Program Handbook. Added new handbook name for the Family Planning Handbook.
Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook	Revised Women's Health Services Handbook name references as Healthy Texas Women (HTW) Program Handbook. Added new handbook name for the Family Planning Handbook.
Health and Human Services Commission (HHSC) Family Planning Program Handbook	Moved HHSC Family Planning Program information from the Women's Health Services handbook to it's own handbook and updated the HHSC Family Planning Program Policy Manual links throughout the handbook.
Healthy Texas Women (HTW) Program Handbook	Renamed Women's Health Services Handbook as Healthy Texas Women (HTW) Program Handbook and added new HTW Plus section.
Home Health Nursing and Private Duty Nursing Services Handbook	Added 15 minute increment table to the claims filing section as a reference for providers.
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook	Policy updated to add the following statement to the Reimbursement section of the policy: “Neuromuscular devices and the implantation codes must be billed on the same day by any provider.” Added and removed some diagnosis codes to be in alignment with the 2019 and 2020 annual ICD updates throughout section 9.2.26, "Diagnostic Doppler Sonography." Removed add-on procedure codes 61782 and 61783 from the Neurostimulator sections 9.2.43.7, "Dorsal Column Neurostimulator (DCN)," 9.2.43.9, "Intracranial Neurostimulators," and 9.2.43.18, "Revision or Removal of Neurostimulator Devices." Revised Women's Health Services Handbook name references as Healthy Texas Women (HTW) Program Handbook. Added new handbook name for the Family Planning Handbook.
Outpatient Drug Services Handbook	Prior Authorization Criteria for Onasemnogene Abeparvovec-xioi (Zolgensma) to Change for Texas Medicaid December 1, 2020 Information posted October 16, 2020
Radiology and Laboratory Services Handbook	Replaced “Radiology Prior Authorization Request Form” with “Radiology Contractor’s Prior Authorization Request form” in section 3.2.6.2, "Request Form and Documentation."
Telecommunication Services Handbook	Benefits for Telehealth Services to Change for Texas Medicaid December 1, 2020 Information posted October 29, 2020
Vision and Hearing Services Handbook	Hearing Aid Fitting and Dispensing Services Billing Changes for Texas Medicaid and the CSHCN Services Program Effective January 1, 2017 Information posted November 18, 2016

November 2020 Release Notes
Handbook	Related Articles and Notes
Volume 1: Appendix A: State, Federal, and TMHP Contact Information	Updated external broken link in section A.9, "HHSC Open Records Requests."
Volume 1: Section 1: Provider Enrollment and Responsibilities	Important Address Information Needed for Contracted Provider Groups Information posted March 23, 2020
Volume 1: Section 6: Claims Filing	Moved place of service codes 55 and 56 from Inpatient Hospital to Outpatient Hospital in subsection 6.3.1.1, "Place of Service (POS) Coding."
Behavioral Health and Case Management Services Handbook	ICD-10 Special Bulletin, No. 18 Information posted October 2020 Benefit Criteria to Change for Psychotherapy and Psychiatric Diagnostic Evaluation Services Information posted October 16, 2020
Children’s Services Handbook: Medical services (Sections 1-3 and 5-9)	Update to TMPPM Children’s Services Handbook for Freestanding Inpatient Rehabilitation Facility Reimbursement Information posted October 23, 2020 Updated broken link under Diagnostic Audiological Evaluation in section 5.3.11.2.3, “Sensory Screening.”
Children’s Services Handbook: THSteps Dental services (Section 4)	Updated limitation statement for procedure codes D4283 and D4285 in section 4.2.17, "Periodontal Services." Updated reimbursement statement for dental examination procedure codes D0601, D0602, and D0603 in section 4.2.3.7, "Diagnostic Services."
Clinics and Other Outpatient Facility Services Handbook	ICD-10 Special Bulletin, No. 18 Information posted October 2020
Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook	ICD-10 Special Bulletin, No. 18 Information posted October 2020
Inpatient and Outpatient Hospital Services Handbook	ICD-10 Special Bulletin, No. 18 Information posted October 2020 Updated broken external link in sections 4.2.3.1 "Inpatient Admissions for Day Surgeries," and 4.5.2 "Outpatient Reimbursement."
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook	ICD-10 Special Bulletin, No. 18 Information posted October 2020 Update to TMPPM Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook Information posted October 27, 2020 Update to ‘Ambulatory and Long-Term Electroencephalogram Benefits to Change for Texas Medicaid October 1, 2020’ Information posted September 29, 2020 Update to TMPPM and CSHCN Services Program Provider Manual for Pediatric Pneumogram Limitation Information posted September 11, 2020
Outpatient Drug Services Handbook	Third Quarter 2020 HCPCS Updated for Texas Medicaid Information posted September 28, 2020 ICD-10 Special Bulletin, No. 18 Information posted October 2020 Prior Authorization Criteria for Burosumab-Twza (Crysvita) to be Updated for Texas Medicaid Effective November 1, 2020 Information posted September 11, 2020
Vision and Hearing Services Handbook	ICD-10 Special Bulletin, No. 18 Information posted October 2020

October 2020 Release Notes
Handbook	Related Articles and Notes
Volume 1: Appendix A: State, Federal, and TMHP Contact Information	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Volume 1: Preliminary Information	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Volume 1: Section 1: Provider Enrollment and Responsibilities	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020 Updated broken links in sections 1.7.1.2, "Reporting Child Abuse or Neglect," and 1.11.1, "Reporting Waste, Abuse and Fraud."
Volume 1: Section 2: Texas Medicaid Fee-for-Service Reimbursement	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Volume 1: Section 3: TMHP Electronic Data Interchange (EDI)	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Volume 1: Section 4: Client Eligibility	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020 Updated broken links in sections 4.4.4, "Submission of Birth Information to Texas Vital Statistics Unit," and 4.10, "Health Insurance Premium Payment (HIPP) Program."
Volume 1: Section 5: Fee-for-Service Prior Authorizations	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Volume 1: Section 6: Claims Filing	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020 Updated statement in section 6.14, "Claims Filing Deadlines," to replace "detail charges" with "detail changes." Updated broken link in section 6.3.3.1.3, "Rate Hearings For New HCPCS Codes."
Volume 1: Section 7: Appeals	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Volume 1: Section 8: Third Party Liability (TPL)	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Ambulance Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Behavioral Health and Case Management Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020 Added asterisks to procedure codes 90833, 90836, and 90838 in section 8.5, "Reimbursement and Limitations."
Certified Respiratory Care Practitioner (CRCP) Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Children’s Services Handbook: Medical services (Sections 1-3 and 5-9)	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020 Removed some outdated claim form examples in Section 9, "Claim Form Examples."
Children’s Services Handbook: THSteps Dental services (Section 4)	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Clinics and Other Outpatient Facility Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020 Added miscellaneous procedure code B9998 table with descriptions to section 2.2.18.1.
Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020 Added text "ordering" to section 5.3, "Prior Authorization."
Home Health Nursing and Private Duty Nursing Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Inpatient and Outpatient Hospital Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Medicaid Managed Care Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020 Added text "ordering" to the prior authorization section 9.2.15.3.3, "Prior Authorization for Genetic Testing for Colorectal Cancer."
Medical Transportation Program Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Outpatient Drug Services Handbook	Reimbursement Rate Updates for Procedure Code J9177 Effective July 1, 2020 Information posted September 3, 2020 Teprotumumab-trbw (Tepezza), a Benefit of Texas Medicaid, Will Require Prior Authorization Effective October 1, 2020 Information posted August 14, 2020 New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Physical Therapy, Occupational Therapy, and Speech Therapy Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Radiology and Laboratory Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020 Added text "ordering" to section 2.2.6, "Breast Cancer Gene 1 and 2 (BRCA) Testing." Added text "ordering" to section 2.2.10.1, "Documentation Requirements."
Telecommunication Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020 Telemonitoring Benefits to Change for Texas Medicaid October 1, 2020 Information posted August 14, 2020
Vision and Hearing Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020
Women’s Health Services Handbook	New Look and Features for the TMHP Website Available September 14, 2020 Information posted July 31, 2020

September 2020 Release Notes
Handbook	Related Articles and Notes
Appendix B: Vendor Drug Program (Merged with new Outpatient Drug Services Handbook)	Notes: Merged contents of the Vendor Drug Program handbook with the Clinician-Administered Drugs Handbook that has been renamed as Outpatient Drug Services Handbook.
Section 5: Fee-for-Service Prior Authorizations (posted August 31, 2020)	Notes: Updated eviCore websites and method of submissions for PA requests to eviCore throughout section 5.
Behavioral Health and Case Management Services Handbook (posted August 31, 2020)	Notes: Revised language throughout section 9 to align with medical policy.
Children’s Services Handbook: THSteps Dental services (Section 4) (posted August 31, 2020)	Related Articles: Texas Health Steps Therapeutic Dental Benefit Changes Effective September 1, 2020 Information posted July 17, 2020 Notes: Removed section for implant services as these services are not a benefit of Medicaid. Added new dental plan to table of Section 4.2.5, “Children's Medicaid Dental Plan Choices.”
Clinician-Administered Drugs (CAD) Handbook (Merged with new Outpatient Drug Services Handbook)	Related Articles: Prior Authorization Criteria for Luspatercept-aamt (Reblozyl) Effective September 1, 2020 Information posted July 17, 2020 Single-Dose Vial Unused Portion Reimbursement Policy for Clinician Administered Drugs Information posted June 16, 2020 Botulinum Toxin Type A and B Benefits to Change for Texas Medicaid, Effective September 1, 2020 Information posted August 7, 2020 Second Quarter 2020 HCPCS Updates for Texas Medicaid Information posted June 30, 2020 Reimbursement Rate Updates for Procedure Code J9358 Effective July 1, 2020 Information posted July 31, 2020 Benralizumab, Mepolizumab, and Reslizumab Benefits to Change for Texas Medicaid September 1, 2020 Information posted August 6, 2020 Notes: Added relationship statement for the injection pegfilgrastim procedure code J2505 to section 7.19, "Colony Stimulating Factors (Filgrastim, Pegfilgrastim, and Sargramostim)." Added vial dosage information to section 4, “Reimbursement.” Merged contents of the Vendor Drug Program handbook with the Clinician-Administered Drugs Handbook. The CAD handbook was renamed as Outpatient Drug Services Handbook. Contents of CAD and VDP were reorganized. CAD injections table was removed and a section was created for each injection that currently was not in an existing section. Standard prior authorization language was moved from some sections and a general prior authorization section was created. Some tables were reformatted throughout the handbook.
Inpatient and Outpatient Hospital Services Handbook (posted August 31, 2020)	Notes: Removed invalid Radiology Prior Authorization Request Form from section 9, "Forms." Added new subsection 3.7.1 with language regarding Inpatient claim submissions.
Medicaid Managed Care Handbook (posted August 31, 2020)	Related Articles: Update to TMPPM Medicaid Managed Care Handbook to Include HCBS-AMH as Carve-Out Services Information posted July 6, 2020
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (posted August 31, 2020)	Related Articles: Genetic Testing for Colorectal Cancer Prior Authorization Language Updated, Effective September 1, 2020 Information posted July 17, 2020
Outpatient Drug Handbook (posted August 31, 2020)	Notes: The Clinician-Administered Drugs (CAD) handbook has been renamed as the Outpatient Drug Services Handbook.
Radiology and Laboratory Services Handbook (posted August 31, 2020)	Related Articles: Genetic Testing for Colorectal Cancer Prior Authorization Language Updated, Effective September 1, 2020 nformation posted July 17, 2020 Notes: Removed invalid Radiology Prior Authorization Request form and updated method of submissions for PA requests to eviCore.

August 2020 Release Notes
Handbook	Related Articles and Notes
Section 5: Fee-for-Service Prior Authorizations (posted July 31, 2020)	Notes: Revised the contacts and fax number table in section 5.5.2.2 "TMHP Prior Authorization Requests by Fax.”
Section 6: Claims Filing (posted July 31, 2020)	Notes: Removed the note "Texas Medicaid does not pay for drug wastage" in section 6.3.4.3, "Drug Rebate Program.” Added note in subsection 6.2.5.3, "Interpretations," to clarify the use of modifier 26.
Section 8: Third Party Liability (TPL) (posted July 31, 2020)	Notes: Updated section 8.3.1, "Exceptions," to add Blind and Visually Impaired Services and Healthy Texas Women to the list of most common non-TPR sources.
Clinician-Administered Drugs (CAD) Handbook (posted July 31, 2020)	Related Articles: Single-Dose Vial Unused Portion Reimbursement Policy for Clinician-Administered Drugs Information posted June 16, 2020 Second Quarter 2020 HCPCS Updates for Texas Medicaid Information posted June 30, 2020 Antisense Oligonucleotide Benefits to Change for Texas Medicaid Effective August 1, 2020 Information posted July 31, 2020 Notes: Added vial dosage information to section 4, “Reimbursement.” Removed statement, "Texas Medicaid does not pay for any drug wastage from single-use or multi-use vials," in section 6.1.3, “Single and Multi-Use Vials.” Added clarifying language to statement within the bulleted list in section 6.1.4, “Nonspecific, Unlisted, or Miscellaneous Procedure Codes.” Revised procedure code J7288, as it should be listed as J2788 in the table of Section 32, “Immune Globulin.”
Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook (posted July 31, 2020)	Notes: Revised language in section 4.18, "Obstetric Ultrasound" for procedure codes 76810, 76812, and 76814, as they must be billed by the same provider.
Medicaid Managed Care Handbook (posted July 31, 2020)	Notes: Corrected the zip code in section 2.10.1, “Medicaid Managed Care Complaints and Fair Hearings.”
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (posted July 31, 2020)	Related Articles: Updates to the Texas Medicaid Provider Procedures Manual Effective August 1, 2020 Information posted July 3, 2020 Notes: In the complex closure procedure codes table of Section 9.2.21, “Closure of Wounds,” removed extra digit from procedure code 131022, as it should be listed as 13102
Medical Transportation Program Handbook (posted July 31, 2020)	Notes: Replaced "Prior authorization number" with "MTP authorization number" in section 2.3, "Claims Filing for ITPs," to align with the H3017 form.
Vision and Hearing Services Handbook (posted July 31, 2020)	Related Articles: Updates to the Texas Medicaid Provider Procedures Manual Effective August 1, 2020 Information posted July 3, 2020

July 2020 Release Notes
Handbook	Related Articles and Notes
Appendix A: State, Federal, and TMHP Contact Information (posted June 30, 2020)	Related Articles: Update to TMPPM for the Term ImmTrac Information posted June 5, 2020
Appendix D: Acronym Dictionary (posted June 30, 2020)	Related Articles: Update to TMPPM for the Term ImmTrac Information posted June 5, 2020
Section 1: Provider Enrollment and Responsibilities (posted June 30, 2020)	Related Articles: Update to TMPPM for the Term ImmTrac Information posted June 5, 2020 Notes: Updated subsection 1.2.4, "Receiving Paper Checks" to add accounting address.
Section 6: Claims Filing (posted June 30, 2020)	Related Articles: Effective June 26, 2020, New Field to be Added to Remittance and Status Report Information posted May 8, 2020
Section 8: Third Party Liability (TPL) (posted June 30, 2020)	Notes: Removed section regarding Claims Forwarded to Other Insurance Carriers.
Children’s Services Handbook (posted June 30, 2020)	Related Articles: Update to TMPPM for the Term ImmTrac (Updates made to Appendix B: Immunizations, Appendix F: THSteps Quick Reference Guide, and Medical Services (Sections 1-3 and 5-9) Information posted June 5, 2020 Notes: Updated broken link for the ImmTrac website in Section B.3.5.2, "Electronic Data Transfer (Import)."
Clinician-Administered Drugs (CAD) Handbook (posted June 30, 2020)	Related Articles: Esketamine (Spravato) to Become a Benefit for Specialty Pharmacy Providers Effective July 1, 2020 Information posted June 5, 2020 Calaspargase Pegol-Mknl a Benefit for Texas Medicaid April 1, 2020 Information posted June 4, 2020 Prior Authorization Criteria for Crizanlizumab-tmca (Adakveo) Effective July 1, 2020 Information posted June 5, 2020 Prior Authorization Criteria for Brexanolone (Zulresso) Effective July 1, 2020 Information posted June 12, 2020
Inpatient and Outpatient Hospital Services Handbook (posted June 30, 2020)	Related Articles: Reimbursement Criteria Updated for Brachytherapy and Therapeutic Radiopharmaceuticals Effective July 1, 2020 Information posted May 15, 2020
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (posted June 30, 2020)	Related Articles: Update to TMPPM for the Term ImmTrac Information posted June 5, 2020 Clarification to ‘Reimbursement Criteria Updated for Brachytherapy and Therapeutic Radiopharmaceuticals Effective July 1, 2020’ Information posted June 17, 2020 Notes: Corrected misspelled word in the first sentence of the paragraph in Section 9.2.40.4, "Prior Authorization Requirements."
Radiology and Laboratory Services Handbook (posted June 30, 2020)	Related Articles: Claims Filing for Medicare-Enrolled Speech-Language Pathologists, Effective June 1, 2020 Information posted April 17, 2020 Update to Texas Medicaid Provider Procedures Manual, Radiology and Laboratory Services Handbook Information posted June 26, 2020
Telecommunication Services Handbook (posted June 30, 2020)	Related Articles: Claims Filing for Medicare-Enrolled Speech-Language Pathologists, Effective June 1, 2020 Information posted April 17, 2020
Vision and Hearing Services Handbook (posted June 30, 2020)	Notes: Replaced incorrect procedure code 9902 in section 4.3.5.10, "Ophthalmoscopy and Extended Ophthalmoscopy," with correct procedure code 92202

June 2020 Release Notes
Handbook	Related Articles and Notes
Section 1: Provider Enrollment and Responsibilities (posted May 29, 2020)	Related Articles: Beginning May 1, 2020, Medicare-Enrolled Speech-Language Pathologists May Apply to Enroll as Texas Medicaid Providers Information posted March 13, 2020
Section 7: Appeals (posted May 29, 2020)	Notes: Removed auto-hyphenation in the appeals email address in subsection 7.3.1, "Administrative Claim Appeals."
Clinician-Administered Drugs (CAD) Handbook (posted May 29, 2020)	Related Articles: Benralizumab, Mepolizumab, and Omalizumab Benefits in the Home Setting Information posted May 8, 2020 Additional Diagnosis Code Added for Eculizumab Information posted April 29, 2020 Antisense Oligonucleotides (Eteplirsen and Nusinersen) Benefits to Change for Texas Medicaid Information posted May 1, 2020 Update to “First Quarter 2020 HCPCS Updated for Texas Medicaid” Information posted April 24, 2020 Notes: Added diagnosis codes and place of service to the table of section 6.1.4, "Nonspecific, Unlisted or Miscellaneous Procedure Codes," for Ravilizumab procedure code J1303.
Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook (posted May 29, 2020)	Related Articles Home Health DME and Supplies Exceptional Circumstances Provision for Medicaid Clients 21 Years of Age and Older Information posted April 29, 2020 Notes: Removed language from subsection 2.2.16.31 regarding feeder seats, floor sitters, corner chairs, and travel chairs not considered medically necessary devices.
Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook (posted May 29, 2020)	Related Articles: Home Health DME and Supplies Exceptional Circumstances Provision for Medicaid Clients 21 Years of Age and Older Information posted April 29, 2020
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (posted May 29, 2020)	Related Articles: Home Health DME and Supplies Exceptional Circumstances Provision for Medicaid Clients 21 Years of Age and Older Information posted April 29, 2020
Physical Therapy, Occupational Therapy, and Speech Therapy Services Handbook (posted May 29, 2020)	Related Articles: Claims Filing for Medicare-Enrolled Speech-Language Pathologists, Effective June 1, 2020 Information posted April 17, 2020
Telecommunication Services Handbook (posted May 29, 2020)	Related Articles: Claims Filing for Medicare-Enrolled Speech-Language Pathologists, Effective June 1, 2020 Information posted April 17, 2020
Vision and Hearing Services Handbook (posted May 29, 2020)	Notes: Replaced incorrect procedure code 9902 in section 4.3.5.10, "Ophthalmoscopy and Extended Ophthalmoscopy," with correct procedure code 92202.

May 2020 Release Notes
Handbook	Related Articles and Notes
Section 1: Provider Enrollment and Responsibilities (posted April 30, 2020)	Related Articles: TMHP Approved Vendor for Credit Balance and Recovery Information posted February 24, 2020 Notes: Updated address locations to add accounting/mailing address.
Behavioral Health and Case Management Services Handbook (posted April 30, 2020)	Related Articles: Benefit Criteria to Change for Inpatient and Outpatient Mental Health Services for Texas Medicaid Information posted April 17, 2020
Children’s Services Handbook: Medical services (Sections 1-3 and 5-9) (posted April 30, 2020)	Related Articles: April 2020 Second Quarter NCCI Updates for Texas Medicaid Information posted March 20, 2020 Notes: Updated link in Section 7.5, “Assistance with Program,” to direct providers to the appropriate HHS THSteps web page for program information. For clarify purposes, removed statement, “Stainless steel crowns and permanent allmetal cast crowns are not reimbursed on anterior permanent teeth (6-11, 22-27),” from section 4.2.15, “Restorative Services.”
Clinician-Administered Drugs (CAD) Handbook (posted April 30, 2020)	Related Articles: Tildrakizumab (Ilumya) to Become a Benefit of Texas Medicaid Effective May 1, 2019 Information posted August 7, 2019
Clinics and Other Outpatient Facility Services Handbook (posted April 30, 2020)	Notes: Corrected hyperlinks to direct providers to the appropriate CMS NCCI web page. Removed hyperlink to NCCI policy manual in section 2.4.2.1, “National Correct Coding Initiative (NCCI and Medically Unlikely Edit (MUE) Guidelines.” Other sections throughout the provider manual do not include a hyperlink.
Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook (posted April 30, 2020)	Related Articles: New Quantity Limitation for Procedure Code 87798 Information posted April 3, 2020
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (posted April 30, 2020)	Related Articles: Updates to TMPPM and CSHCN Services Program Provider Manual for Genetic Services Reimbursement Criteria for Procedure Codes 99254 and 99255 Information posted March 27, 2020 Notes: Updated link in Section 9.2.34.3, “Vaccine Adverse Event Reporting System (VAERS),” to direct providers to the appropriate web page for the Reportable Events Table.
Radiology and Laboratory Services Handbook (posted April 30, 2020)	Related Articles: New Quantity Limitation for Procedure Code 87798 Information posted April 3, 2020

April 2020 Release Notes
Handbook	Related Articles and Notes
Volume 1: Section 1: Provider Enrollment and Responsibilities (posted March 31, 2020)	Related Articles: Reminder: Provider Enrollment Revalidation Requirements Information posted March 20, 2020 Notes: Removed invalid Provider EVV Vendor Selection Form from section 1.13, “Forms.”
Volume 2: Behavioral Health and Case Management Services Handbook (posted March 31, 2020)	Related Articles: Reminder: Claims Filing for Opioid Treatment Providers Information posted February 28, 2020
Children’s Services Handbook: Medical services (Sections 1-3 and 5-9) (posted March 31, 2020)	Notes: Added procedure codes to the OEFV limitation statement in subsection 5.3.12.1, "Oral Evaluation and Fluoride Varnish (OEFV) in the Medical Home."
Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook (posted March 31, 2020)	Related Articles: Definition Clarification for Back-up and Replacement Ventilators for Respiratory Equipment and Supplies Information posted March 6, 2020 Therapeutic Continuous Glucose Monitors to Become a Benefit of Texas Medicaid April 1, 2020 Information posted March 6, 2020
Inpatient and Outpatient Hospital Services Handbook (posted March 31, 2020)	Notes: Removed procedure codes 55862, 55865, and 92974 for ASC and HASC facilities
Medicaid Managed Care Handbook (posted March 31, 2020)	Notes: Revised and reorganized language throughout handbook.
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (posted March 31, 2020)	Related Articles: Benefit Changes for Gene Expression Profiling Procedure Code 81519 Effective March 1, 2020 Information posted January 10, 2020 Correction to ‘Allergy Testing Evaluation and Management Limitation Language Updated’ Information posted February 27, 2020
Radiology and Laboratory Services Handbook (posted March 31, 2020)	Related Articles: Limitation for Specimen Validity Testing Procedure Codes Information posted February 14, 2020 Notes: Revised language regarding waived tests and use of modifier QW for CLIA certificates.

March 2020 Release Notes
Handbook	Related Articles and Notes
Section 1: Provider Enrollment and Responsibilities (posted February 28, 2020)	Related Articles: Update to Automated Provider Licensure Information System Information posted February 28, 2020 Notes: Revised language regarding outpatient behavioral health services performed by licensed professionals. Revised language and added subsection to clarify claims filing during enrollment. Updated language to clarify Texas Health Steps-Medical alternate addresses require a separate application
Section 6: Claims Filing (posted February 28, 2020)	Notes: Added bullet to specify providers can continue to file claims when revalidating an existing enrollment.
Behavioral Health and Case Management Services Handbook (posted February 28, 2020)	Related Articles: Updated Benefit Information for MAT Services for Texas Medicaid March 1, 2020 Information posted February 7, 2020
Children’s Services Handbook: THStesps Dental Services (section 4), and Medical services (Sections 1-3 and 5-9) (posted February 28, 2020)	Notes: Added text to specify that FQHCs and RHCs are not required to be enrolled as THSteps providers in subsection 5.2.1, "THSteps Medical Provider Enrollment." Updated parental accompaniment statement in section 4.2.25, "Orthodontic Services (THSteps)," for consistency with the legally approved parental accompaniment language.
Clinics and Other Outpatient Facility Services Handbook (posted February 28, 2020)	Notes: In section 4.3.1, "Claims Information," the last sentence in the first paragraph was rearranged to be listed as the first sentence at the beginning of the paragraph for clarity purposes.
Inpatient and Outpatient Hospital Services Handbook (posted February 28, 2020)	Related Articles: Update to Texas Medicaid Provider Procedures Manual, Inpatient and Outpatient Hospital Handbook Information posted January 17, 2020 Notes: Removed Stereotactic Radiosurgery section from the handbook. Removed "refer to" in subsection 4.2.7, "Chemotherapy Administration." Removed outdated statement referencing Milliman Care Guidelines from subsection 3.6.2, "Recommendations to Enhance Compliance with Texas Medicaid Fee-for-Service Hospital Claims Submission." Added new subsection to specify outpatient observation services.
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (posted February 28, 2020)	Notes: Removed the Chemotherapy section from the handbook.
Medical Transportation Program Handbook (posted February 28, 2020)	Notes: Removed lodging and meal provider sections.
Telecommunication Services Handbook (posted February 28, 2020)	Related Articles: Telehealth Services Will Become a Benefit for Early Childhood Intervention Providers Effective March 1, 2020 Information posted January 6, 2020

February 2020 Release Notes
Handbook	Related Articles and Notes
Volume 1: Section 1: Provider Enrollment and Responsibilities (posted January 31, 2020)	Notes: Revised the language regarding enrollment effective dates in subsection 1.1.7, “Provider Enrollment Application Determination."
Behavioral Health and Case Management Services Handbook (posted January 31, 2020)	Notes: Added language regarding prior authorization submission to subsection 9.9.4, "Prior Authorization for Residential Treatment Services."
Children’s Services Handbook: Medical services (Sections 1-3 and 5-9) and THSteps Dental services (Section 4) (posted January 31, 2020)	Related Publications: 2020 Healthcare Common Procedure Coding System (HCPCS) Special Bulletin, No. 17 Information posted December 31, 2019 2020 HCPCS Updates for Texas Medicaid SHARS Program – Counseling and Psychological Services Information posted January 23, 2020
Clinics and Other Outpatient Facility Services Handbook (posted January 31, 2020)	2020 Healthcare Common Procedure Coding System (HCPCS) Special Bulletin, No. 17 Information posted December 31, 2019
Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook (posted January 31, 2020)	2020 Healthcare Common Procedure Coding System (HCPCS) Special Bulletin, No. 17 Information posted December 31, 2019
Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (posted January 31, 2020)	2020 Healthcare Common Procedure Coding System (HCPCS) Special Bulletin, No. 17 Information posted December 31, 2019 Diagnostic Doppler Sonography Benefits to Change for Texas Medicaid February 1, 2020 Information posted December 13, 2019 Clarification Language for After-Hours Services Limitation Effective February 1, 2020 Information posted December 13, 2019 Allergy Testing Evaluation and Management Limitation Language Updated Information posted December 13, 2019
Radiology and Laboratory Services Handbook (posted January 31, 2020)	2020 Healthcare Common Procedure Coding System (HCPCS) Special Bulletin, No. 17 Information posted December 31, 2019 Limitation Update for Urinalysis and Chemistry Procedure Code 84583 Effective February 1, 2020 Information posted December 13, 2019
Telecommunication Services Handbook (posted January 31, 2020)	2020 Healthcare Common Procedure Coding System (HCPCS) Special Bulletin, No. 17 Information posted December 31, 2019
Vision and Hearing Services Handbook (posted January 31, 2020)	2020 Healthcare Common Procedure Coding System (HCPCS) Special Bulletin, No. 17 Information posted December 31, 2019
Women’s Health Services Handbook (posted January 31, 2020)	2020 Healthcare Common Procedure Coding System (HCPCS) Special Bulletin, No. 17 Information posted December 31, 2019

January 2020 Release Notes
Handbook	Related Articles and Notes
Volume 1: Section 1: Provider Enrollment and Responsibilities (posted December 31, 2020)	Notes: Updated links in subsections 1.1.9.9, "Franchise Tax Account Status Page," and 1.3.1, "Excluded Entities And Providers."
Volume 1: Section 5: Fee-for-Service Prior Authorizations (posted December 31, 2020)	Notes: Added language regarding a Change of Provider letter in section 5.9, "Closing a Prior Authorization."
Volume 1: Section 6: Claims Filing (posted December 31, 2020)	Notes: Updated Claims Filing Deadline calendars in subsections 6.1.4 and 6.1.6.
Vision and Hearing Services Handbook (posted December 31, 2020)	Related Articles: Benefit Changes for Vision Services Non-Surgical Procedure Code 92242 Effective January 1, 2020 Information posted December 20, 2019