Hearing Services Claims for Clients with Medicaid HMOs

Information posted October 30, 2009: All hearing services claims for clients who are birth through 20 years of age must be submitted to TMHP regardless of the clients’ Medicaid managed care plans.
For clients who are 21 years of age or older, the claim for hearing services must be submitted to TMHP for fee-for-service clients or to the appropriate Medicaid managed care plan, either to TMHP for Primary Care Case Management (PCCM) clients or to the appropriate health maintenance organization (HMO) for clients with another Medicaid managed care plan.
Standard third-party resource (TPR) rules apply to all hearing services claims.
For more information, call the TMHP Contact Center at 1-800-925-9126.