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Reimbursement Rate Updates for Procedure Code J0248, Effective January 21, 2022

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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.

Starting March 17, 2022, for dates of service on or after January 21, 2022, the reimbursement rates for procedure code J0248 will be implemented for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program.

To view the updates, click the following link: Procedure Code J0248

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:

  • Call the TMHP Contact Center at 1-800-925-9126.
  • Call TMHP-CSHCN Services Program Contact Center at 1-800-568-2413.