Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.
This is an update to an article titled, “New Provider Type for Local Health Departments Effective December 31, 2022,” which was posted on the TMHP website on December 22, 2022.
All current providers enrolled in Medicaid that qualify for local health department (LHD) services now have the option to enroll as an LHD.
LHD Procedure Codes
Beginning April 14, 2023, LHD providers will be added as a payable provider type for the following procedure codes:
11976 |
11981 |
11982 |
11983 |
58300 |
58301 |
71045 |
71046 |
71047 |
74018 |
80048 |
82465 |
83655 |
80051 |
80053 |
80055 |
80061 |
80076 |
80081 |
81000 |
81001 |
81002 |
81003 |
81005 |
81025 |
82040 |
82247 |
82248 |
82565 |
82947 |
83036 |
83718 |
83721 |
83735 |
84075 |
84443 |
84450 |
84460 |
84478 |
84520 |
85018 |
85025 |
88175 |
86480 |
86481 |
86580 |
86592 |
86593 |
86682 |
86689 |
86701 |
86702 |
86703 |
86704 |
86705 |
86706 |
86708 |
86750 |
86780 |
86787 |
86803 |
87015 |
87116 |
87140 |
87164 |
87190 |
87205 |
87207 |
87210 |
87253 |
87270 |
87320 |
87340 |
87341 |
87389 |
87490 |
87491 |
87521 |
87535 |
87556 |
87590 |
87591 |
87661 |
87798 |
87808 |
87810 |
88150 |
88164 |
90460 |
90461 |
90471 |
90472 |
90473 |
90474 |
90619 |
90621 |
90632 |
90633 |
90636 |
90647 |
90648 |
90654 |
90655 |
90656 |
90657 |
90658 |
90660 |
90661 |
90662 |
90670 |
90672 |
90673 |
90674 |
90675 |
90680 |
90681 |
90682 |
90685 |
90686 |
90687 |
90688 |
90696 |
90697 |
90698 |
90700 |
90702 |
90707 |
90710 |
90713 |
90714 |
90715 |
90716 |
90723 |
90732 |
90734 |
90736 |
90739 |
90740 |
90743 |
90744 |
90746 |
90747 |
90750 |
90756 |
92002 |
92004 |
92014 |
92015 |
96156 |
96158 |
96159 |
96164 |
96165 |
96167 |
96168 |
96372 |
97802 |
97804 |
99000 |
99078 |
99091 |
99173 |
99199 |
99202 |
99203 |
99204 |
99205 |
99211 |
99212 |
99213 |
99214 |
99215 |
99385 |
99386 |
99387 |
99395 |
99406 |
99407 |
99461 |
99492 |
99493 |
A4267 |
A4268 |
A4269 |
D0120 |
D0140 |
D0145 |
D0150 |
D0160 |
D0170 |
D0180 |
D0210 |
D0220 |
D0230 |
D0240 |
D0270 |
D0272 |
D0274 |
D0330 |
D0340 |
D0350 |
D0367 |
D0460 |
D0470 |
D0601 |
D0602 |
D0603 |
D1110 |
D1120 |
D1206 |
D1208 |
D1310 |
D1330 |
D1351 |
D1352 |
D1510 |
D1516 |
D1517 |
D1520 |
D1526 |
D1527 |
D1551 |
D1552 |
D1553 |
D1556 |
D1558 |
D1575 |
D2140 |
D2150 |
D2160 |
D2161 |
D2330 |
D2331 |
D2332 |
D2335 |
D2390 |
D2391 |
D2392 |
D2393 |
D2394 |
D2740 |
D2750 |
D2751 |
D2752 |
D2791 |
D2792 |
D2799 |
D2920 |
D2930 |
D2931 |
D2932 |
D2933 |
D2934 |
D2940 |
D2950 |
D2954 |
D2971 |
D2999 |
D3110 |
D3120 |
D3220 |
D3230 |
D3240 |
D3310 |
D3320 |
D3330 |
D3346 |
D3347 |
D3348 |
D3351 |
D3352 |
D3353 |
D3999 |
D4211 |
D4277 |
D4278 |
D4283 |
D4285 |
D4341 |
D4342 |
D4355 |
D4910 |
D4999 |
D5110 |
D5120 |
D5211 |
D5212 |
D5213 |
D5214 |
D5410 |
D5411 |
D5421 |
D5422 |
D5520 |
D5612 |
D5630 |
D5640 |
D5650 |
D5660 |
D5670 |
D5671 |
D5720 |
D5721 |
D5730 |
D5731 |
D5740 |
D5741 |
D5750 |
D5760 |
D5761 |
D5820 |
D5821 |
D5899 |
D5992 |
D5993 |
D6240 |
D6549 |
D6750 |
D6930 |
D6999 |
D7111 |
D7140 |
D7210 |
D7220 |
D7230 |
D7250 |
D7270 |
D7286 |
D7510 |
D7550 |
D7910 |
D7961 |
D7962 |
D7970 |
D7971 |
D7997 |
D7999 |
D8050 |
D8060 |
D8080 |
D8210 |
D8220 |
D8660 |
D8670 |
D8680 |
D8690 |
D9110 |
D9210 |
D9211 |
D9212 |
D9215 |
D9223 |
D9230 |
D9243 |
D9248 |
D9310 |
D9430 |
D9630 |
D9910 |
D9930 |
D9940 |
D9944 |
D9951 |
D9971 |
D9974 |
D9999 |
G0433 |
G0475 |
G0506 |
G9873 |
G9874 |
G9875 |
G9876 |
G9877 |
G9878 |
G9879 |
G9880 |
H0033 |
J0561 |
J0696 |
J1050 |
J1055 |
J1580 |
J3490 |
J7297 |
J7298 |
J7300 |
J7301 |
J7307 |
S4993 |
S9470 |
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.