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.
This is a correction to an article titled “Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Codes Effective January 1, 2021 and September 1, 2021,” which was published on the TMHP website on August 13, 2021. The article listed incorrect reimbursement rates for some procedure codes in the tables titled Nonclinical Laboratory and Nonclinical Laboratory – Rural Hospitals.
The following links go to the correct information:
For more information:
- Refer to the Health and Human Services (HHS) Rate Analysis webpage at hhs.texas.gov/rate-packets.
- Call the TMHP Contact Center at 800-925-9126.