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.
Effective for dates of service on or after March 1, 2022, reimbursement rate changes and updates for procedure codes, which were presented at a public rate hearing on December 13, 2021, will be implemented.
Effective for Dates of Service on or After March 1, 2022
The following topics were covered at the public rate hearing:
- Calendar Fee Review for:
- Special Review for:
For more information:
- Refer to the Health and Human Services (HHS) “Rate Packets” web page at hhs.texas.gov/rate-packets.
- Call the TMHP Contact Center at 800-925-9126.