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.
Effective for dates of service on or after September 1, 2023, reimbursement rate changes and updates for Texas Health Steps dental procedure code D1354 that were presented at a public rate hearing on May 19, 2023, will be implemented for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program.
To view the updates, click the following link: Dental Procedure Code D1354
For more information, call the TMHP Contact Center at 800-925-9126, or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.