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Provider Rate Updates for HCS and TxHmL Providers

Last updated on 6/1/2022

In early May 2022, HHSC identified missing or incorrect rate keys for some HCS/TxHmL providers. On May 11 and May 12, 2022, HHSC completed updates to rate keys for these HCS/TxHmL providers based on rates published on the Provider Finance website: 2022-hcs-awards.pdf (texas.gov)

Providers do not need to take action on claims that have already processed to Paid or Approved to Pay status, as those claims will systematically adjust during the regularly scheduled retro adjustment process. Retroactive adjustments occur each Saturday in the Texas Medicaid and Healthcare Partnership (TMHP) Claims Management System (CMS). Depending on status of claims, adjustments will occur within one to two weeks of a rate key change. Providers should confirm claim status and paid amounts on their Remittance and Status (R&S) Report.

After confirming rates with Provider Finance and paid claims on the R&S Report, contact the TMHP LTC Help Desk at 800-626-4117, Option 1, then Option 7, if you have additional questions.