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Claims for Telephone (Audio Only) Behavioral Health Services

Last updated on 3/26/2020

This information has been updated. For details, see CSHCN COVID-19 Telehealth and Telemedicine Extensions through March 31, 2021.

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

To help ensure continuity of care during the COVID-19 (coronavirus) response, the Children with Special Health Care Needs (CSHCN) Services Program is authorizing providers to submit claims for dates of service March 20, 2020, through April 30, 2020, for reimbursement of the following behavioral health services delivered by telephone (audio only):

Description of Services

Procedure Codes

Psychiatric Diagnostic Evaluation

90791, 90792

Psychotherapy

90832, 90834, 90837, 90846, 90847, 90853

Peer Specialist Services

H0038

Screening, Brief Intervention, and Referral to Treatment (SBIRT)

99408, G2011, H0049

Substance Use Disorder Services

H0001, H0004,H0005

Mental Health Rehabilitation

H0034, H2011, H2012, H2014, H2017

To indicate the occurrence of remote delivery, providers should continue to use the 95 modifier.

Providers can refer to the CSHCN Services Program Provider Manual, Chapter 29, “Outpatient Behavioral Health,” for additional information about CSHCN behavioral health benefits and Chapter 38, “Telecommunication Services” for additional information about CSHCN telemedicine and telehealth services.

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