The following tables show the section and handbooks that were changed in the CSHCN Services Program Provider Manual. The changes are listed in reverse chronological order (newest first).
To see the changes made in 2021, see the 2021 Release Notes.
December 2022 CSHCN Provider Manual Release Notes |
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Chapter |
Related Articles and Notes |
No updates for December 2022. |
November 2022 CSHCN Provider Manual Release Notes |
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Chapter |
Related Articles and Notes |
Removed TPI from acronym list. |
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Added prior authorization requirement statement, limitation statement, and documentation of medical necessity statement to procedure code D0367 in the table of subsection 14.2.3.5, "Radiographs or Diagnostic Imaging.” Added limitation statements to the table of subsection 14.2.6.9, "Adjunctive General Services" for procedure codes D9420 and D9612. Changed "same provider" to "any provider" in the statement, "If more than two nonintravenous (IV) conscious sedation services are required by the same provider in a 12 month period, prior authorization is required.” Added medical necessity statement to subsection 14.2.7.1, “Dental Hospital Calls" for procedure code D9420. |
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Third Quarter 2022 HCPCS Updates for the CSHCN Services Program Information posted September 30, 2022 |
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Third Quarter 2022 HCPCS Updates for the CSHCN Services Program Information posted September 30, 2022 |
October 2022 CSHCN Provider Manual Release Notes |
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Chapter |
Related Articles and Notes |
Added authorization and replacement language to section 17.3. Removed 1- from phone numbers. |
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Restrictions to Be Updated for Some Injection Procedure Codes Information posted September 30, 2022 |
September 2022 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Chapter 5: Claims Filing, Third-Party Resources, and Reimbursement |
Updated Instructions and Resubmission Guidelines for UB-04 CMS 1450 Paper Claims Information posted July 1, 2022 |
Information posted August 22, 2022 |
August 2022 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Information posted September 1, 2021 |
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Changed PO box address from 149347 to 149030 in sections 1.1.2 and 1.3.1. |
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Changed PO box address from 149347 to 149030 in section 2.2. |
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Information posted September 1, 2021 Changed PO box address from 149347 to 149030 in sections 3.2.8 and 3.3.2. |
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Changed PO box address from 149347 to 149030 in sections 4.5.3 and 4.5.4. |
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Chapter 5: Claims Filing, Third-Party Resources, and Reimbursement |
Changed PO box address from 149347 to 149030 in section 5.1.9. |
Information posted September 1, 2021 |
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Information posted September 1, 2021 Changed PO box address from 149347 to 149030 in sections 7.2.1, 7.2.2, 7.3.5, 7.3.6, and 7.4. |
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Chapter 8: Advanced Practice Registered Nurse (APRN [NP/CNS]) |
Reminder: TMHP Provider Enrollment and Management System (PEMS) Information posted June 1, 2022 |
Reminder: TMHP Provider Enrollment and Management System (PEMS) Information posted June 1, 2022 Update to CSHCN Services Program Provider Manual for Dental Procedure Codes D0470 and D8670 Information posted June 17, 2022 |
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Information posted September 1, 2021 |
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Information posted September 1, 2021 |
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Added limitation statement "Therapy evaluations or re-evaluations are limited to four per 180 days, any provider," to section 21.3.4, "Occupational Therapy (OT), Physical Therapy (PT), and Speech-Language Pathology (SLP) Services." |
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Information posted September 1, 2021 |
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Information posted September 1, 2021 |
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Reminder: TMHP Provider Enrollment and Management System (PEMS) Information posted June 1, 2022 |
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Second Quarter 2022 HCPCS Updates for the CSHCN Services Program Information posted June 22, 2022 |
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Reminder: TMHP Provider Enrollment and Management System (PEMS) Information posted June 1, 2022 |
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Information posted September 1, 2021 |
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Information posted September 1, 2021 |
July 2022 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Updated limitation for 9-A4326 and 9-A4349 and added a new note to the footer table in section 18.2.1. |
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CSHCN Provider Manual Update for Emergency Inpatient Hospital Admissions Information posted June 17, 2022 |
June 2022 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Changed TPR to TPL in section 7.3.1.2. |
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Information posted May 17, 2022 Information posted April 15, 2022 Removed the reimbursement limitation statement for procedure code D4341, and revised the limitation statement in the table of section 14.2.6.6, "Periodontics." |
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Information posted October 22, 2021 |
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Information posted May 17, 2022 |
May 2022 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Reminder: TMHP Provider Enrollment and Management System (PEMS) Information posted March 1, 2022 Information posted April 1, 2022 Changed TAC 38.6 to 351.6 in section 2.3. |
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Changed 25 TAC 38.16 to 26 TAC 351.16. |
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Changed 25 TAC 38.16 to 26 TAC 351.16. |
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Changed 25 TAC 38.10 and 38.13 to 26 TAC 351.10 and 351.13. |
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Chapter 8: Advanced Practice Registered Nurse (APRN [NP/CNS]) |
Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Changed 25 TAC 38.6 to 26 TAC 351.6 in section 10.1. |
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Changed 25 TAC 38.6 to 26 TAC 351.6 in section 11.1. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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CSHCN Services Program Provider Manual Update for Restorative Dental Services Information posted March 11, 2022 Added limitation statement for retainer arch procedure code D8680 to section 14.2.4.3, "Submitting Local Codes for Orthodontic Procedures." Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. Removed statement, "Restorations do not require prior authorization except for inlay or onlay restorations and crowns (single restorations only) in excess of four in a lifetime by any provider," from section 14.2.6.4, "Restorations." |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Chapter 19: Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) |
Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Changed 25 TAC 38.6 and 38.10 to 26 TAC 351.6 and 351.10. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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First Quarter 2022 HCPCS Updates for the CSHCN Services Program Information posted April 1, 2022 Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
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Updated per TAC rule changes. Title 25 moved to 26 and DSHS Chapter 38 changed to HHSC Chapter 351.6 for Providers. |
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Changed 25 TAC 38.6 to 26 TAC 351.6. |
April 2022 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Chapter 5: Claims Filing, Third-Party Resources, and Reimbursement |
Updated holiday calendar in section 5.1.8. |
Update to TMPPM and CSHCN Services Program Provider Manual for Dental Procedure Code D2951 Information posted February 11, 2022 |
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QW Modifier Required for Procedure Code 87801 Information posted February 11, 2022 |
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Update to Age and Diagnosis Restrictions for Injection Drugs for the CSHCN Services Program Information posted March 18, 2022 |
March 2022 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Coming Soon: TMHP Provider Enrollment and Management Systems (PEMS) |
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Changed inpatient rehabilitation facility/unit to inpatient hospital in section 24.3.1.4.1. |
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Prior Authorization Criteria for Surgical Implantation of HNS Effective March 1, 2022 for the CSHCN Services Program |
January 2022 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Replaced incorrect FSS Enrollment hyperlink with updated link. Coming Soon: TMHP Provider Enrollment and Management System (PEMS) |