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Telemedicine Information Updated in the TMPPM

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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 September 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update telemedicine information in the following subsections of the Texas Medicaid Provider Procedures Manual (TMPPM), Telecommunication Services Handbook:

  • Subsection 3.1, “Patient Health Information Security”—TMHP will remove the reference to the requirement stating that a health professional must be present with the child for school-based telemedicine.
  • Subsection 3.4.1, “Distant Site”—TMHP will remove the reference to out-of-state physicians to align with the recently amended Texas Administrative Code (TAC) rules relating to telemedicine services.
  • Subsection 3.4.2.1, “Prescriptions Generated from a Telemedicine Medical Service”—TMHP will update the TAC rule references for the treatment of clients with acute pain and compliance requirements for prescriptions issued through a telemedicine service.

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