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Update to Outpatient Drug Services Handbook for Hematopoietic Injections

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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.

On August 1, 2023, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual, Outpatient Drug Services Handbook, section 6.40, “Hematopoietic Injections.”

Benefit information for clients with end-stage renal disease (ESRD) who are on dialysis, including procedure codes J0882 and J0887, will be removed.

Refer to the current Texas Medicaid Provider Procedures Manual, Clinics and Other Outpatient Facility Services Handbook, section 6.2.2, “Renal Dialysis Facilities-Consolidated Billing,” for information about procedure codes J0882 and J0887.

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