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Modifiers U1 and U2 Required for Certain Claims Submitted with Procedure Code T1015 by RHC Providers

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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.

Beginning June 5, 2025, for dates of service on or after January 1, 2024, rural health centers (RHCs) that submit certain claims with procedure code T1015 must include:

  • Modifier U1 for licensed professional counselors (LPCs).
  • Modifier U2 for licensed marriage and family therapists (LMFTs).

The Texas Health and Human Services Commission (HHSC) will use these modifiers to better determine how clients use services that are provided in the RHC setting.

TMPPM Manual Update

The Texas Medicaid & Healthcare Partnership (TMHP) will update the following sections in the Texas Medicaid Provider Procedures Manual (TMPPM), Clinics and Other Outpatient Facility Services Handbook to include the U1 and U2 modifiers:

  • Section 7.2.1.1, “Encounter Rates”
  • Section 7.2.1.3, “Freestanding Rural Health Clinic Services”
  • Section 7.2.3, “Hospital-Based Rural Health Clinic Services”

CSHCN Provider Manual Update

TMHP will also add the U1 and U2 modifiers to the Children with Special Health Care Needs (CSHCN) Services Program Provider Manual, Chapter 19: Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC), subsection 19.2.1, “General Medical Services.”

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.