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Claims Filing for Medicare-Enrolled Speech-Language Pathologists, Effective June 1, 2020

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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 June 1, 2020, Medicare-enrolled speech-language pathologists (SLPs) who have been assigned a new SLP provider identifier will be eligible to bill Medicaid for SLP services for clients of all ages, including those who are Medicare-Medicaid dual eligible.

Providers may refer to the previous article titled, “Beginning May 1, 2020, Medicare-Enrolled Speech-Language Pathologists May Apply to Enroll as Texas Medicaid Providers,” which was published on this website on March 13, 2020, for further information about the new SLP provider identifier.

Providers should refer to the Texas Medicaid Provider Procedures Manual, Physical Therapy, Occupational Therapy, and Speech Therapy Services Handbook for additional information regarding speech therapy benefits.

For more information, call the TMHP Contact Center at 800-925-9126.