The total component (TOS 4) is the valid type of service for procedure code 37210 and may be considered for reimbursement. Procedure code 37210 is not a benefit of the Texas Medicaid Program or the Children with Special Health Care Needs (CSHCN) Services Program when submitted with modifier TC (technical component) or 26 (interpretation/professional component).

Procedure code 4-37210 requires a rate hearing to establish a reimbursement rate.

Reminder: Services that are provided before rates have been implemented through the rate hearing process will be denied as part of another service until the applicable reimbursement rate has been implemented. The client cannot be billed for these services. TMHP will reprocess claims after the applicable reimbursement rates have been implemented. Providers should submit claims for the procedure codes as the services are performed so that all filing deadlines are met. Providers are responsible for meeting all filing deadlines and for appealing any claims that are denied between the date the procedure code is effective and the date on which the reimbursement rate is implemented.

For more information, call the TMHP Contact Center at 1-800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413.