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Correction to “Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Codes Effective March 1, 2022”

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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.

This is a correction to the article titled “Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Codes Effective March 1, 2022,” which was published on this website on July 21, 2022. The original article featured incorrect information in the Discontinued procedure codes (cardiac magnetic resonance imaging) spreadsheet. The discontinued procedure codes are only for non-hospital providers; the procedure codes remain payable for hospital providers. The affected spreadsheet has been updated and now features the correct reimbursement information.

The Texas Medicaid & Healthcare Partnership (TMHP) will reprocess any affected claims that are identified. Providers are not required to appeal the claims unless they are denied for additional reasons after reprocessing is completed.

Reimbursement Rate Changes Effective for Dates of Service on or After March 1, 2022

Calendar Fee Review for:

Healthcare Common Procedure Coding System (HCPCS) for:

Medical Policy Review for:

Special Review for:

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