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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.
The following Medicaid and Children’s Health Insurance Plan (CHIP) COVID-19 flexibilities have been extended through December 31, 2021. The Health and Human Services Commission (HHSC) is extending these flexibilities through December 31, 2021, because it includes teleservices that are being analyzed in alignment with House Bill 4.
HHSC will provide more information if there are changes.
- “Correction to ‘COVID-19 Guidance: Targeted Case Management Through Remote Delivery’”
- “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”
For more information, call the TMHP Contact Center at 800-925-9126.