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Therapeutic Phlebotomy a CSHCN Benefit Effective May 1, 2021

Last updated on 4/2/2021

Effective for dates of service on or after May 1, 2021, procedure code 99195 for therapeutic phlebotomy will become a benefit of the Children with Special Health Care Needs (CSHCN) Services Program.

Procedure code 99195 may be reimbursed to physician assistant, advanced practice registered nurse (APRN), physician, physician group, and clinic/group practice providers in the office or outpatient hospital settings.

Procedure code 99195 is restricted to the following diagnosis codes:

  • D45
  • D649
  • D750
  • D751
  • E800
  • E801
  • E8020
  • E8021
  • E8029
  • E8310
  • E83110
  • E83118
  • E8319
  • P611

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