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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, precertification, 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 Medicaid COVID-19 flexibilities described in the following articles have been extended through April 30, 2022. The Texas Health and Human Services Commission (HHSC) is extending these flexibilities because they include teleservices that are being analyzed in alignment with House Bill 4.
- “Correction to ‘COVID-19 Guidance: Targeted Case Management Through Remote Delivery’”
- “Claims for Telephone (Audio Only) Medical Services”
- “RHC Reimbursement for Telemedicine and Telehealth Services”
- “SHARS Services Provided Through Telemedicine or Telehealth”
- “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”
- “Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered)” for Healthy Texas Women (HTW) and Family Planning Program (FPP) claims
- “Claims for Telemedicine and Telehealth Services for HTW Plus”
The guidance provided in the following notices will end effective January 31, 2022, because it has been replaced by related interim guidance:
- “Claims for Telehealth Service for Occupational, Physical, and Speech Therapy”
- Refer to HB4: Interim Guidance for Physical Therapy, Occupational Therapy, Speech Therapy Services Delivered by Synchronous Audiovisual for additional information.
- “Claims for Telephone (Audio Only) Behavioral Health Services”
- Refer to HB4: Behavioral Health Services Delivered by Synchronous Audio-visual or Telephone (Audio-only) Interim Guidance for additional information.
For more information, call the TMHP Contact Center at 800-925-9126.