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WARNING: THIS IS A TEXAS HEALTH AND HUMAN SERVICES INFORMATION RESOURCES SYSTEM THAT CONTAINS STATE AND/OR U.S. GOVERNMENT INFORMATION. BY USING THIS SYSTEM YOU ACKNOWLEDGE AND AGREE THAT YOU HAVE NO RIGHT OF PRIVACY IN CONNECTION WITH YOUR USE OF THE SYSTEM OR YOUR ACCESS TO THE INFORMATION CONTAINED WITHIN IT. BY ACCESSING AND USING THIS SYSTEM YOU ARE CONSENTING TO THE MONITORING OF YOUR USE OF THE SYSTEM, AND TO SECURITY ASSESSMENT AND AUDITING ACTIVITIES THAT MAY BE USED FOR LAW ENFORCEMENT OR OTHER LEGALLY PERMISSIBLE PURPOSES. ANY UNAUTHORIZED USE OR ACCESS, OR ANY UNAUTHORIZED ATTEMPTS TO USE OR ACCESS, THIS SYSTEM MAY SUBJECT YOU TO DISCIPLINARY ACTION, SANCTIONS, CIVIL PENALTIES, OR CRIMINAL PROSECUTION TO THE EXTENT PERMITTED UNDER APPLICABLE LAW.
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AMA/ADA End User License Agreement
LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT® ")

You, your employees and agents are authorized to use CPT only as contained in materials on the Texas Medicaid & Healthcare Partnership (TMHP) website solely for your own personal use in directly participating in healthcare programs administered by THHS. You acknowledge that AMA holds all copyright, trademark and other rights in CPT.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, Intellectual Property Services, 515 N. State Street, Chicago, Illinois, 60610. Applications are available at the American Medical Association website, www.ama-assn.org/go/cpt.

U.S. Government Rights

This product includes CPT which is commercial technical data and/or computer databases and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer databases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.

Disclaimer of Warranties and Liabilities

CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the American Medical Association (AMA) is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this product is with THHS, and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product.

This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

Should the for egoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "accept".

THE LICENSE GRANTED HEREIN IS EXPRESSLY CONTINUED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED "ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD, AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.

IF YOU DO NO AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN.

IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.

1. Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights included in the materials.

2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago IL 60611. Applications are available at the American Dental Association web site, http://www.ADA.org.

3. U.S. GOVERNMENT RIGHTS. Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government Use. This product includes CDT, which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the American Dental Association, 211 East Chicago Avenue, Chicago Illinois, 60611. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal Procurements.

4. ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CDT. The ADA does no t directly or indirectly practice medicine or dispense dental services. The sole responsibility for the software, including any CDT and other content contained therein, is with TMHP or the CMS; and no endorsement by the ADA is intended or implied. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of the Agreement. The ADA is a third party beneficiary to this Agreement.

5. CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled "ACCEPT". If you do not agree to the terms and conditions, you may not access or use the software. Instead, you must exit from this computer screen.

Multiple Medicaid COVID-19 Flexibilities Extended and Ending

Last updated on 4/29/2022

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.

This is an update to the article titled “Update to ‘Multiple Medicaid COVID-19 Flexibilities Extended Through April 30, 2022’ to Permanently Implement Rural Health Clinic Flexibility,” which was posted on this website on February 28, 2022.

Some of the Medicaid COVID-19 flexibilities described in the following articles have been extended, and many are ending. Plans for each flexibility are outlined below. The flexibilities in this notice will do one of the following:

Transition to interim guidance on May 1, 2022
End May 31, 2022
Extend to the end of the federal public health emergency (PHE) and end when the federal PHE ends
Extend to May 31, 2022, because the article includes teleservices that are being analyzed in alignment with House Bill (HB) 4

Plans for each specific flexibility are provided here:

School Health and Related Services

Transition to interim guidance on May 1, 2022.

The guidance provided in the following notice will end effective April 30, 2022, because it has been replaced by related interim guidance.

“SHARS Services Provided Through Telemedicine or Telehealth”
Refer to “HB 4: School Health and Related Services (SHARS) Telemedicine or Telehealth Delivered by Synchronous Audio-visual or Telephone (Audio-only) Technology” for the interim guidance.

Behavioral Health and Healthy Texas Women (HTW) Plus

Transition to interim guidance on May 1, 2022, or end May 31, 2022.

The guidance provided in the following notices will either end effective April 30, 2022, because it has been replaced by related interim guidance or will end May 31, 2022.

“Claims for Telemedicine and Telehealth Services for HTW Plus”
Refer to “HTW and HTW PLUS Telemedicine and Telehealth Services Interim Guidance” for HTW and HTW Plus services transitioning to interim guidance.
Refer to “Telephone (Audio-only) Delivery of Some Medicaid and HTW Plus Substance Use Services Ending” for flexibilities that are ending May 31, 2022.
Update to “Claims for Telephone (Audio-only) Behavioral Health Services”
Refer to “Update to HB4: Behavioral Health Services Delivered by Synchronous Audio-visual or Telephone (Audio-only) Interim Guidance” for behavioral health services transitioning to interim guidance.
Refer to “Telephone (audio-only) Delivery of Some Medicaid and HTW Plus Substance Use Services Ending” for flexibilities that are ending May 31, 2022.

Healthy Texas Women (HTW) and Family Planning Program

Transition to interim guidance on May 1, 2022, or extend to May 31, 2022, because articles include teleservices that are being analyzed in alignment with HB4.

The guidance provided in the following notices will either end effective April 30, 2022, because it has been replaced by related interim guidance or be extended through updated COVID flexibility notices.

“Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered)” for Healthy Texas Women (HTW) and Family Planning Program (FPP) claims.
Refer to “HTW and HTW PLUS Claims for Telemedicine and Telehealth Services Interim Guidance” for HTW and HTW Plus services transitioning to interim guidance.
Refer to “Update to Healthy Texas Women Claims for Telemedicine (Physician Delivered) and Telephone (Audio Only) Services” for updated extended flexibilities being analyzed in alignment with HB4.
Refer to “Update to Family Planning Claims for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered)” (to be posted soon) for services transitioning to interim guidance.

Case Management

Transition to interim guidance on May 1, 2022, or extend to the end of the federal public health emergency (PHE) and end when the federal PHE ends.

The guidance provided in the following notices will either end effective April 30, 2022, because it has been replaced by related interim guidance or end when the federal PHE ends.

“COVID-19 Guidance: Targeted Case Management Through Remote Delivery “ and “Correction to ‘COVID-19 Guidance: Targeted Case Management Through Remote Delivery’”
Refer to “Update to HB4: Behavioral Health Services Delivered by Synchronous Audio-visual or Telephone (Audio-only) Interim Guidance” for behavioral health services transitioning to interim guidance.
Refer to “HB 4: Interim Guidance ECI TCM Telemedicine or Telehealth Delivered by Synchronous Audio-visual or Telephone (Audio-only) Technology” for case management services transitioning to interim guidance.
Additional guidance sent to providers directly through program contacts for Case Management for Blind and Visually Impaired Children and Case Management for Children and Pregnant Women, and through information letters for Intellectual and Developmental Disability Targeted Case Management.

Texas Health Steps

Extend to the end of the federal PHE and end when the federal PHE ends.

The guidance provided in the following notice will end when the federal PHE ends.

“Texas Health Steps Checkup Guidance Extended Through July 31, 2020”
Refer to “Texas Health Steps Flexibilities for Telemedicine (audio-visual) and Telephone (audio-only) Delivery Ending at End of PHE” for end of PHE guidance.

ECI Specialized Skills Training

Extend to the end of the federal PHE and end when the federal PHE ends.

The guidance provided in the following notice will end when the federal PHE ends.

“Claims for Telephone (Audio-only) Early Childhood Intervention Specialized Skills Training”
Refer to “Flexibilities for Telephone (Audio-Only) Early Childhood Intervention Specialized Skills Training Ending at End of PHE” for flexibilities that are ending at the end of the PHE.

Nutrition Counseling

Extend to the end of the federal PHE and end when the federal PHE ends.

The guidance provided in the following notice will end when the federal PHE ends.

“Claims for Telephone (Audio-only) Nutritional Counseling Services”
Refer to “Flexibilities for Telephone (audio-only) Nutritional Counseling Services Ending at End of PHE” for flexibilities that are ending at the end of the PHE.

Medical Office Visits

Extend to May 31, 2022, because article includes teleservices that are being analyzed in alignment with HB 4.
The guidance provided in the following article is extended to May 31, 2022.
“Claims for Telephone (Audio-only) Medical Services”
See also related information outlined in this article, “Reimbursement Rate Updates for Procedure Codes Related to COVID-19.”

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