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TMPPM Update for Dental Procedure Code D0470

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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.

On August 1, 2022, the Texas Medicaid and Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM), Children’s Services Handbook section 3.2.3.7, “Diagnostic Services,” to add limitation criteria.

Procedure code D0470 is limited to once per lifetime, any provider.

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