Provider Alert! June 2022 TMPPM Procedure Code Updates
Date: June 1, 2022
Attention: All Providers
Effective Date: June 1, 2022
Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with the COVID-19 event. TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that the Health and Human Services Commission (HHSC) staff continues to revise the Texas Medicaid Provider Procedures Manual (TMPPM) Outpatient Drug Services Handbook.
How this impacts providers: HHSC will remove procedure codes J9219, J9600, and Q0139 from the June 2022 Outpatient Drug Services Handbook. Please refer to the table below for details of the change.
| Procedure Code | Affected Subsection | Additional Information |
| J9219 | 7.57 “Leuprolide Acetate (Lupron Depot)” | Procedure code is not a benefit. All other procedure codes in this subsection remain a benefit of Medicaid. |
| J9600 | 7.7.16 “Porfimer (Photofrin)” | Procedure code is not a benefit |
| Q0139 | 7.53 “Iron Injections” | Refer to the Clinics and Other Outpatient Facility Services Handbook, subsection 6.2.2, “Renal Dialysis Facilities-Consolidated Billing,” for information about procedure code Q0139 |
For more information, call the TMHP Contact Center at 800-925-9126.
Next steps for providers: Prescribers should share this communication with their staff
If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers
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