Skip to main content

Additional Place of Service Added for Epoetin Alfa Procedure Code Q4081

Last updated on

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 August 1, 2024, procedure code Q4081 Epoetin Alfa may be reimbursed for physician assistant, nurse practitioner, clinical nurse specialist, and physician providers for services rendered in the office setting and for hospital and rural emergency hospital providers for services rendered in the outpatient hospital setting.

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