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Group Provider Claims for THSteps
Information posted July 28, 2008: Group providers are not required to submit a rendering or performing provider identifier on claims for Texas Health Steps (THSteps) medical services. Groups can enroll and bill for THSteps medical services; however, their enrollment is not set up as a group.
Electronic claims for THSteps medical services must be submitted with the THSteps billing provider’s National Provider Identifier (NPI), benefit code, and the TMHP attested taxonomy code. Failure to supply the taxonomy code for the billing provider may result in the rejection of claims.
Paper claim submissions must be submitted with the billing provider’s NPI, Texas Provider Identifier (TPI), and benefit code.
THSteps medical claims must be submitted with the appropriate modifier. Refer to the 2008 Texas Medicaid Provider Procedures Manual, Section 43, “Texas Health Steps (THSteps).”
For more information, call the TMHP Contact Center at 1-800-925-9126.
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