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TMPPM Update to for Tuberculosis Services

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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.

Beginning April 1, 2022, Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual, Clinics and Other Outpatient Facility Services Handbook, section 8.2.2, “Ancillary Services,” to clarify the limitation for lab-handling charges.

Lab-handling charges (procedure codes 99000 and 99001) will be limited to one per day for each client unless specimens are sent to two or more different laboratories. If specimens are sent to two or more different laboratories, the information must be documented on the claim.

For more information, call the TMHP Contact Center at 800-925-9126.