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Procedure Codes 92652 and 92653 to Become Available for Audiologists, Portable X-Ray Suppliers, Radiological and Physiological Laboratory Providers Beginning July 1, 2021

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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.

Beginning July 1, 2021, Healthcare Common Procedure Coding System (HCPCS) procedure codes 92652 and 92653 (for evoked response tests and neuromuscular), will become available for audiologists, portable X-ray suppliers, radiological and physiological laboratory providers who render laboratory services to Texas Medicaid clients.

Claims submitted with dates of service from January 1, 2021, through June 8, 2021, may be reprocessed. Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete. When claims are reprocessed, providers may receive additional payment, which will be reflected on Remittance and Status (R&S) Reports.

Refer to the Texas Medicaid Procedures Manual, Medical and Nursing Specialists, Physicians and Physician Assistants Handbook, subsection 9.2.27.3, ”Evoked Potential Testing,” for additional information such as limitations and reimbursement.

For more information, call the TMHP Contact Center at 800-925-9126.