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.
On October 1, 2021, TMHP will implement the International Classification of Diseases, Tenth Revision (ICD-10) changes effective for dates of service on or after October 1, 2021. The update includes the Clinical Modification (ICD-10-CM) diagnosis code changes and the Procedure Coding System (ICD-10-PCS) surgical procedure code changes.
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.