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Correction to DME New Benefit Procedure Code Reimbursement Rate
Information posted September 11, 2009: This is a correction to an article that was posted on this website on June 26, 2009, and published in the September/October 2009 Texas Medicaid Bulletin, No.225, and in the November 2009 CSHCN Services Program Provider Bulletin, No. 72, titled “DME New Benefit Procedure Code Reimbursement Rate.” The article listed an incorrect reimbursement rate for procedure code 9-K0739. Click on the title to view the details.

The following is the correct information: Effective for dates of service on or after July 1, 2009, the reimbursement rate for benefit procedure code 9-K0739 is $13.41. This procedure code is a benefit of both Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program for clients of all ages.

Procedure code 9-K0739 may be billed with prior authorization for non-warranty repairs of durable medical equipment (DME) and may be reimbursed to home health DME suppliers and medical DME suppliers in the home setting. Procedure code 9-K0739 will be denied if it is billed with the same date of service as procedure code 9-E1340 by any provider.

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.

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