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Update to TMPPM Durable Medical Equipment Handbook for Enteral Nutritional Products Available February 1, 2025

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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.

On February 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM), Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook, subsection 2.2.18.1, “Enteral Nutritional Products, Feeding Pumps, and Feeding Supplies,” to include the following:

Food thickener may be considered for clients with a swallowing disorder. Procedure code B4100 is reimbursed per unit; 1 unit = 1 ounce. Food thickener option (powder, gel, or liquid) should be appropriate for the client’s medical condition.

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