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, 2020, procedure code S8301 for infection control supplies above and beyond normal protocol can be billed by THSteps-CCP personal care services (PCS) providers in the home setting.
Affected claims submitted with dates of service on or after April 1, 2020, may be reprocessed. When the claims are reprocessed, providers may receive additional payment, which will be reflected on Remittance and Status (R&S) Reports.
For more information, call the TMHP Contact Center at 800-925-9126.