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Correction to “Update on Case Management for CPW Policy Changes and COVID-19 Flexibilities”

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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.

The Texas Health and Human Services Commission (HHSC) is correcting a previous notice updating the direction and providing clarification related to COVID-19 flexibilities for Case Management for Children and Pregnant Women (CPW) services and guidance on National Correct Coding Initiative (NCCI) practices for CPW claims.

The COVID-19 flexibilities for CPW services, to include comprehensive visits delivered via telephone (audio-only) telecommunications, were allowed beginning March 24, 2020, and ended May 11, 2023, when the public health emergency ended. See “Multiple COVID-19 Flexibilities for Services Ending.”

This is a correction to the article “Update on Case Management for CPW Policy Changes and COVID-19 Flexibilities,” which was published on the Texas Medicaid & Healthcare Partnership (TMHP) website on January 17, 2023. On January 17, 2023, these flexibilities were updated to align with NCCI practices.

The table in the article listed the service for procedure code G9012 with modifier 93 incorrectly. The service should be “Follow-up visit telephone (audio-only)” and not “Follow-up visit (in-person or synchronous audiovisual).”

Below is the correct table:

Procedure Codes and Modifiers


Submitted Procedure Code

Modifier 1

Modifier 2

Modifier 3

Comprehensive visit (in-person or synchronous audiovisual)





Follow-up visit telephone (audio-only)




If providers submitted claims that incorrectly identified modifier 93 or 95 from January 17, 2023, to the date of this correction notice, there will be no penalties assessed.

For more information, see the article “Changes to Case Management for Children and Pregnant Women, Including Teleservices, Effective September 1, 2022” that was published on on July 18, 2022.

Providers can refer to the Behavioral Health and Case Management Services Handbook and the Telecommunication Services Handbook in the Texas Medicaid Provider Procedures Manual for more information.

For details about benefits, limitations, prior authorization, reimbursement, and specific claim processing procedures for case management for children and pregnant women (CPW) services that are delivered through an MCO, providers must refer to the MCO.

For more information, call the TMHP Contact Center at 800-925-9126 or refer to the Texas Medicaid Provider Procedures Manual | TMHP.