Skip to main content

Reimbursement Rate Updates for Procedure Codes U0003, U0004, and U0005 Effective January 1, 2021

Last updated on

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.

Effective January 12, 2021, for dates of service on or after January 1, 2021, the reimbursement rates for COVID-19 related procedure codes U0003, U0004, and U0005 have been updated.

The following link shows the updates: COVID-19 related Procedure Codes U0003, U0004, and U0005

Affected claims with dates of service from January 1, 2021, through January 12, 2021, if any are identified, will be reprocessed. Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is completed.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413.