The Texas Medicaid Provider Procedures Manual was updated on April 30, 2021, and contains all policy changes through May 1, 2021. The manual is available in both PDF and HTML formats.
Claim form examples referenced in the manual can be found on the claim form examples page.
See the release notes for a detailed description of the changes.
For previous editions of the manual, visit the manual archives.
May 2021 Texas Medicaid Provider Procedures Manual
Vol. 1 Preliminary Information (806.02 KB)
Vol. 1 Provider Enrollment and Responsibilities (388.87 KB)
Vol. 1 Client Eligibility (188.82 KB)
Vol. 1 Fee-for-Service Prior Authorizations (171.33 KB)
Vol. 1 Claims Filing (439.42 KB)
Vol. 1 Appeals (143.38 KB)
Vol. 1 Third Party Liability (TPL) (126.9 KB)
Appendix B: HIV/AIDS (83.87 KB)
Appendix C: Acronym Dictionary (80.39 KB)
Ambulance Services Handbook (833.87 KB)
Children's Services Handbook (1.79 MB)
Healthy Texas Women Program Handbook (823.55 KB)
Medical Transportation Program Handbook (796.76 KB)
Medicaid Managed Care Handbook (955.36 KB)
Outpatient Drug Services Handbook (1.07 MB)
Radiology and Laboratory Services Handbook (921.4 KB)
Telecommunication Services Handbook (836.64 KB)
Vision and Hearing Services Handbook (973.11 KB)