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Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Codes Effective June 1, 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.

Beginning June 9, 2022, for dates of service on or after June 1, 2022, reimbursement rate changes and updates for procedure codes presented at a public rate hearing on May 16, 2022, will be implemented.

Effective for Dates of Service on or After June 1, 2022

The following topics were covered at the public rate hearing:

Medical policy review for:

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:

  • Refer to the Health and Human Services (HHS) Rate Analysis webpage at hhs.texas.gov/rate-packets.
  • Call the TMHP Contact Center at 800-925-9126.