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Reimbursement Rate Updates for COVID-19 Genotype Analysis Procedure Code 87913 Effective February 21, 2022

Last updated on 1/27/2023

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 November 10, 2022, for dates of service on or after February 21, 2022, the Texas Medicaid & Healthcare Partnership (TMHP) will implement reimbursement rates for COVID-19 genotype analysis procedure code 87913 for Texas Medicaid, Healthy Texas Women (HTW), the Family Planning Program (FPP), and the Children with Special Health Care Needs (CSHCN) Services Program.

TMHP will reprocess any affected claims that are identified. Providers are not required to appeal the claims unless the claims are denied for additional reasons after reprocessing is completed.

Select the following link to view the updates: COVID-19 Genotype Analysis procedure code 87913.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.