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Updated Texas Health Steps Quick Reference Guide Available November 1, 2024

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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 updated Texas Health Steps Quick Reference Guide will be available on November 1, 2024. The following updates will be made under the Immunizations Administered column:

  • The pneumococcal vaccine PCV21 (procedure code 90684) will be added.
  • Specific COVID-19 vaccines (procedure codes 91304, 91318, 91319, and 91321) will be removed, as these codes are no longer a benefit of Texas Medicaid.

The updated guide will be available on the Texas Health Steps web page.

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