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 Program (CHIP) COVID-19 flexibility has been extended.
This direction will remain in effect through December 31, 2021.
Beginning with dates of service on or after January 1, 2022, this COVID-19 flexibility will end, and the client or guardian signature requirement for the Durable Medical Equipment (DME) Certification and Receipt Form will resume. The Texas Health and Human Services Commission (HHSC) will provide more information if there are changes.
Please refer to the Texas Medicaid Provider Procedures Manual, Volume 2, Durable Medical Equipment and Supplies, Section 2.2.2, “Durable Medical Eqipment and Supplies,” for more information about DME Certification and Receipt Form requirements for services after December 31, 2021.
For more information, call the TMHP Contact Center at 800-925-9126.