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 June 1, 2021, benefits for Screening, Brief Intervention, and Referral to Treatment (SBIRT) services will change for Texas Medicaid.
Skilled nursing facilities, intermediate care facilities and extended care facilities will be added as places of service for SBIRT procedure codes 99408, G2011, and H0049 for the following provider types:
- Physician assistants
- Nurse practitioners
- Clinical nurse specialists
- Licensed professional counselors
- Licensed clinical social workers
- Certified nurse midwives
- Registered nurses
For more information, call the TMHP Contact Center at 800-925-9126.