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Effective April 1, 2022, Reimbursement Rate Updates Implemented for Drug Procedure Code J7352

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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 May 24, 2022, for dates of service on or after April 1, 2022, the reimbursement rates for drug procedure code J7352 will be implemented for Texas Medicaid.

To view the updates, click the following link: Drug Procedure Code J7352

Any affected claims that are identified will be reprocessed. Providers are not required to appeal the claims unless the claims are denied for additional reasons after reprocessing is completed.

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