Provider Alert! COVID-19 Procedure Code Updates for Second Quarter 2022 HCPCS
Date: October 12, 2022
Attention: All Providers
Effective Date: June 23, 2022
Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to 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 Health Plan (TCHP) would like to inform providers that on June 23, 2022, the Texas Medicaid & Healthcare Partnership (TMHP) implemented the second quarter 2022 Healthcare Common Procedure Coding System additions, which include new COVID-19 procedure codes.
How this impacts providers:
COVID-19 Vaccine Administration for Dental Providers
The following procedure codes will be benefits of Texas Medicaid when provided by a federally qualified health center (FQHC) and Texas Health Steps dental providers in the office setting:
| Effective Dates of Service | Procedure Codes | Age Limitations |
| March 11, 2021 | D1701, D1702 | 12 years of age or older |
| March 11, 2021 | D1703, D1704, D1707 | 18 years of age or older |
| March 10, 2022 | D1708, D1709 | 12 years of age or older |
| March 10, 2022 | D1710, D1711, D1712 | 18 years of age or older |
| March 10, 2022 | D1713, D1714 | 5 through 11 years of age |
Note: Effective dates align with the date the procedure codes received approval by the American Dental Association.
The following procedure codes will be benefits of Texas Medicaid and the Children with Special Health Care Needs (CSHCN) when provided by a federally qualified health center (FQHC) and Texas Health Steps dental providers in the office and outpatient setting:
| Effective Dates of Service | Procedure Codes | Age Limitations |
| March 11, 2021 | D1701, D1702 | 12 years of age or older |
| March 11, 2021 | D1703, D1704, D1707 | 18 years of age or older |
| March 10, 2022 | D1708, D1709 | 12 years of age or older |
| March 10, 2022 | D1710, D1711, D1712 | 18 years of age or older |
| March 10, 2022 | D1713, D1714 | 5 through 11 years of age |
Note: Effective dates align with the date the procedure codes received approval by the American Dental Association.
COVID-19 Testing Procedure Code 87913 Effective February 21, 2022
Procedure code 87913 is a benefit of Texas Medicaid and the Healthy Texas Women (HTW) Program for the following providers and places of service:
| Place of Service | Provider Type |
| Office
|
Physician assistant (PA), nurse practitioner (NP), clinical nurse specialist (CNS), physician, certified nurse midwife (CNM), registered nurse (RN), nephrology (hemodialysis, renal dialysis), and renal dialysis facility providers
|
| Outpatient hospital | Hospital providers
|
| Independent laboratory | Laboratory providers
|
Procedure code 87913 is a benefit of the CSHCN Services Program for the following providers and
places of service:
| Place of Service | Provider Type |
| Office
|
Physician providers
|
| Outpatient hospital | Hospital providers
|
| Independent laboratory | Laboratory providers
|
Procedure code 87913 will also be a benefit of the Family Planning Program for FQHC and family planning clinic providers.
Next steps for providers: Providers are encouraged to 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
Leave a Reply