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Injection Procedure Code J2020 – Zyvox (Linezolid) Now a Benefit for Texas Medicaid

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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, injection procedure code J2020 for Zyvox (Linezolid) is a benefit of Medicaid for clients of all ages.

Procedure Code J2020 is a benefit of Medicaid for the following providers and places of service:

Place of Service

Provider Type

Office

Physician assistant, nurse practitioner, clinical nurse specialist, physician, clinic/group practice

Outpatient hospital

Hospital

Any affected claims 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.