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.
Starting October 12, 2021, for dates of service on or after September 1, 2021, reimbursement rates for Cytogenic Constitutional (Genome-wide) Microarray Analysis procedure code 81229 will be implemented. These rates were presented at a public rate hearing on May 25, 2021.
To view the updates, click the following link: Cytogenic Constitutional (Genome-wide) Microarray Analysis Procedure Code 81229
Affected claims, if any are identified, will be reprocessed. Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is completed.
For more information:
- Refer to the Health and Human Services (HHS) Rate Analysis web page at hhs.texas.gov/rate-packets.
- Call the TMHP Contact Center at 800-925-9126.