Provider Alert! STAR Kids Billing RequirementsTexas Children's Health Plan
Attention: STAR Kids Providers
REMINDER: STAR Kids Billing Requirements
As previously communicated, Texas Children’s Health Plan (TCHP) requires all STAR Kids providers billing for private duty nursing (PDN) services with the T1000 CPT code to use the billing matrix available on the Texas Health and Human Services website at https://hhs.texas.gov/laws-regulations/handbooks/star-kids-handbook/appendices/appendix-iii-ltss-billing-matrix-crosswalk. This requirement was effective June 5, 2017.
Failure to use this billing matrix, including placement of modifiers, will result in denials for incorrectly billed services. Providers may receive line denials if all codes and modifiers are not listed as represented on the crosswalk.
For more detail, please visit the TexasChildrensHealthPlan.org website for information and links to the HHSC LTSS Billing Procedures Manual, STAR Kids Handbook and how to contact your Provider Relations staff.
If you have any questions, please call Provider Relations at 1-800-731-8527.