Provider Alert! DME/Supplies Exceeding Medicaid Limitations
Texas Children’s Health Plan applies benefit limitations for DME Supplies and Equipment per the current TMHP Manual for all members eligible to receive the benefit. See benefit exceptions below. Frequency of Billing As a reminder, DME monthly limits will be applied every 27 days. Claims for recurring DME rentals and/or monthly disposable supplies billed prior to this renewal date are subject to denial. Denied claims may be appealed through the standard appeal process with supporting documentation to establish and/or support medical necessity. What...