Effective for dates of service on or after September 1, 2007, FQHCs and RHCs must submit claims for services rendered  to Primary Care Case Management (PCCM) clients before 8 a.m. and after 5 p.m., Monday through Friday, and during weekends and federal holidays with the modifier “TU”. No primary care provider referral is required.

All claims submission requirements remain the same with the addition of the TU modifier when after-hours services are rendered.

Claims for dates of service between September 1, 2007, and September 28, 2007, that meet the criteria outlined above will be reprocessed 45 days after September 29, 2007, and payments will be adjusted accordingly. No action on the part of the provider is required for reprocessing. Effective for dates of service September 29, 2007, claims submitted with the after hours modifier will be automatically processed. No reprocessing will occur.

For more information, call the TMHP Contact Center at 1-800-925-9126 or the PCCM Provider Helpline 1-888-834-7226.