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.
The following Medicaid and Children’s Health Insurance Plan (CHIP) COVID-19 flexibilities have been extended through May 31, 2021:
- “Correction to ‘COVID-19 Guidance: Targeted Case Management Through Remote Delivery’”
- “Waiver Extension for DME Certification and Receipt Form”
- “Claims for Telephone (Audio-Only) Behavioral Health Services”
- “Claims for Telephone (Audio-Only) Medical Services”
- “RHC Reimbursement for Telemedicine and Telehealth Services”
- “SHARS Services Provided Through Telemedicine or Telehealth”
- “Claims for Telehealth Service for Occupational, Physical, and Speech Therapy”
- “Claims for Telephone (Audio-Only) Early Childhood Intervention Specialized Skills Training”
- “Claims for Telephone (Audio-Only) Nutritional Counseling Services”
- “Texas Health Steps Checkup Guidance Extended Through July 31, 2020”
HHSC will provide updated information if there are changes. For more information, call the TMHP Contact Center at 800-925-9126.