Provider Alert! Patient LiftsTexas Children's Health Plan
Attention: Primary Care and DME Providers
Effective Date: July 3, 2020
Call to action: In accordance with Texas Medicaid Provider Procedure Manual (TMPPM), patient lifts will require prior authorization, except for E0637 & E0641when billed outside of the benefit limitations. Click here for the Prior Authorization Form.
Coding information for lifts as an addition to the mobility aids that are already on the Prior Authorization list.
|E0630*||Hydraulic//mechanical lift. This code has a limit of 1 purchase every 5 years and 1 month rental.|
|E0635*||Portable lift. Include modifier TG for purchase of a client lift and is limited to once per lifetime (any provider) without modifier is limited to 1 per 5 years.
|E0621||Sling/seat lift. Limited to one every 5 years.|
|E0637||Combination sit-to-stand frame/table system. No limit.|
|E0641*||Standing frame/table system, multi-position. Limited to 1 per 5 years.|
*The limits may not apply with evidence of medical necessity.
Resource: Texas Medicaid Provider Procedure Manual (TMPPM) mobility aids information
How this impacts providers: Providers will be reimbursed for patient lifts according to TMPPM standards and should follow the coding information posted above and available from TMPPM.
Next steps for providers: Providers should coordinate this change with their billing staff.
If you have any questions, please email Provider Network Management at: firstname.lastname@example.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.
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