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 April 1, 2021, reimbursement rate changes and updates for some procedure codes that were presented at a public rate hearing on February 5, 2021, will be implemented.
The following topic was covered at the public rate hearing:
Effective for dates of services on or after April 1, 2021
- Calendar Fee Review for:
For more information:
- Refer to the Health and Human Services (HHS) Rate Analysis web page at rad.hhs.texas.gov/rate-packets.
- Call the TMHP Contact Center at 800-925-9126.