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Added Diagnosis Codes for Nutritional Products-CCP

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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.

Effective March 1, 2021, for dates of service on or after January 1, 2021, additional diagnosis codes will be added for nutritional products Comprehensive Care Program (CCP) for Texas Medicaid.

The following diagnosis codes will be added and may be reimbursed for nutritional products without prior authorization:

Added Diagnosis Codes
M3581 M3589        

Providers may refer to the current Texas Medicaid Provider Procedures Manual, Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook, subsection 2.2.18.2.2 “Clients who are 20 years of age and younger,” for additional nutritional products information.

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