Information posted April 14, 2020
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.
Beginning May 29, 2020, revenue codes will be included on 277CA Claims Acknowledgement files. This enhancement will allow providers and clearinghouses that submit claims electronically through Electronic Data Interchange (EDI) to see the revenue code in the response.
Providers that have questions, require changes to their system, or will be impacted by this change should contact the TMHP EDI Helpdesk at 888-863-3638.
Note: These changes will apply only for providers that submit claims electronically. No provider response or changes are required.
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.