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Reimbursement Rate Updates for Certain Covid-19 Clinical Diagnostic Laboratory Services Procedure Codes

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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.

Effective for dates of service on or after March 1, 2024, and September 1, 2024, reimbursement rate updates for certain Covid-19 clinical diagnostic laboratory services procedure codes will be implemented for Texas Medicaid, Healthy Texas Women (HTW), the Family Planning Program (FPP), and the Children with Special Health Care Needs (CSHCN) Services Program.

To view the updates, access:

For more information, call the Texas Medicaid & Healthcare Partnership (TMHP) Contact Center at 800-925-9126.