This article has been updated. To view the updated information, see “Multiple COVID-19 Flexibilities for Services Ending.”
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 with the end of the federal public health emergency (PHE), the Texas Health and Human Services Commission (HHSC) will end the temporary flexibility that has been allowed for nutritional counseling services described below. This article is intended to notify providers that this change will occur. When HHSC receives notice from federal authorities that the PHE is ending, an article will be issued to announce the end date.
To help ensure continuity of care during the COVID-19 (coronavirus) response, HHSC is authorizing providers to bill procedure code S9470 for telephone (audio-only) nutritional counseling delivered from March 15, 2020, through the end of the federal public health emergency. Providers should continue to use modifier 95 to indicate that remote delivery has occurred.
Providers can refer to the Texas Medicaid Provider Procedures Manual, Telecommunication Services Handbook for additional information about the Texas Medicaid telehealth services benefit.
For more information, call the TMHP Contact Center at 800-925-9126.