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Reimbursement Rate Changes and Updates for Texas Medicaid Effective March 1, 2021

Last updated on 2/23/2021

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.

Effective for dates of service on or after March 1, 2021, reimbursement rate changes and updates for procedure codes that were presented at a public rate hearing on November 13, 2020, will be implemented.

Providers are required to seek Medicare reimbursement for dual eligible clients, including for telemonitoring procedure code 99091.

The following topics were covered at the public rate hearing:

Effective for dates of services on or after March 1, 2021

For more information:

  • Call the TMHP Contact Center at 800-925-9126.