Tag - COVID
09May

Provider Alert! HHSC to End Telephone (Audio-only) Medical Services COVID-19 Guidance and Issue Temporary Guidance for Certain Audio-Only Services

Date: May 8, 2023 Attention: All Providers Effective date: May 12, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective May 11, 2023, Health and Human Services Commission (HHSC) will end the temporary flexibility that has been allowed for telephone (audio-only) medical (physician-delivered) E/M services. HHSC authorized providers to bill procedure codes 99201-99205 and 99211-99215 to receive reimbursement for telephone (audio-only) medical (physician-delivered) E/M services delivered from March 20, 2020, through May 11, 2023. Billing information: Providers should...

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08May

Provider Alert! Monovalent Moderna and Pfizer-BioNTech COVID-19 Vaccines Removed From Formulary on April 21, 2023

Date: May 8, 2023 Attention: All Providers Effective Date: April 21, 2023 Call to action: Texas Children Health Plan (TCHP) would like to inform providers that effective April 21, 2023, the U.S. Food and Drug Administration (FDA) amended the emergency use authorizations of the Moderna and Pfizer-BioNTech COVID-19 bivalent mRNA vaccines. This is to simplify the vaccination schedule for most individual vaccines, and monovalent are no longer authorized for use in the United States. This announcement includes authorizing the current bivalent vaccines (original and...

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18Apr

Provider Alert! COVID-19 Vaccine Counseling Procedure Code G0315 Now a Benefit

Date: April 14, 2023 Attention: All Providers Effective Date: Dates of service on or after December 2, 2021 Call to action: Texas Children Health Plan (TCHP) would like to inform providers that effective for dates of service on or after December 2, 2021, COVID-19 vaccine counseling procedure code G0315 is a benefit of Medicaid for individuals birth through 20 years of age. How this impacts providers: Procedure code G0315 will be limited to once per day for the same provider, as well as three...

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22Mar

Provider Alert! Provider Enrollment Revalidation Extensions to End on May 11, 2023

Date: March 21, 2023 Attention: All Providers Call to action: Effective May 11, 2023, the Health and Human Services Commission (HHSC) will end the flexibility of extended Medicaid provider revalidation dates that came due during the COVID-19 public health emergency (PHE). How this impacts providers: Per federal guidance, providers that were due for revalidation effective March 1, 2020, through May 11, 2023, will receive a post-PHE grace period to complete the revalidation process. Texas Medicaid and Healthcare Partnership (TMHP) will notify providers in...

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22Mar

Provider Alert! HHSC Policy Flexibility for Member State Fair Hearings ends on May 11, 2023

Date: March 21, 2023 Attention: All Providers Call to action: The Health and Human Services Commission (HHSC) is ending the additional 30 days a member has to request a fair hearing starting May 12, 2023. For services provided up until May 11, 2023, Texas Children’s Health Plan (TCHP) will allow the additional 30 days. For services provided beginning May 12, 2023, and ongoing, the normal policy of allowing no less than 90 calendar days and no more than 120 calendar days from...

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22Mar

Provider Alert! Federal Public Health Emergency Set to End May 11, 2023 – Update on COVID Flexibilities

Date: March 21, 2023 Attention: All Providers Call to action:  The Health and Human Services Commission (HHSC) has received notice that the COVID-19 federal public health emergency (PHE) declared January 31, 2020, will end on May 11, 2023. In response to the PHE, HHSC implemented certain flexibilities for Texas Children’s Health Plan and other managed care organizations (MCOs) and dental maintenance organizations (DMOs), providers and members, and has issued guidance through MCO Notices with dates to reflect when that guidance is set...

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21Mar

Provider Alert! Reinstatement of CHIP Co-pays for Medical Office Visits

Date: March 20, 2023 Attention: All Providers Effective Date: May 12, 2023 Call to action: In response to the COVID-19 public health emergency (PHE), the Health and Human Services Commission (HHSC) waived co-pays for Children’s Health Insurance Program (CHIP) medical office visits beginning March 13, 2020. HHSC will reinstate co-pays for CHIP medical office visits on May 12, 2023, because the federal PHE ends on May 11, 2023. The reinstatement of medical office visit co-pays does not apply to: COVID-19-related office visits for COVID-19...

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14Feb

Provider Alert! COVID-19 UPDATE ALERT #4 – Telemedicine Services – Physicians, BH, FQHC and RHC Providers

Date: February 10, 2023 Attention: All providers  Effective Date: January 30, 2023 The content in this message on Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission. The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March...

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13Feb

Provider Alert! Telemedicine/Telehealth claims guidance Provider Alert!

Date: February 10, 2023    Attention: All Providers Effective Date: January 30, 2023 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: TCHP supports the delivery of telehealth (non-physician-delivered) and telemedicine distant site services to its members. The purpose of this alert is to provide guidance on...

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13Feb

Provider Alert! Provider Alert! Guidance on Appeals and Fair Hearing Requests due to COVID-19

Date: February 10, 2023 Attention: All providers Effective Date: January 30, 2023 The content in this message will remain in effect through April 30, 2023 as announced by the Health and Human Services Commission (HHSC). TCHP COVID-19 Utilization Management Procedure and provider alerts can be found here: http://www.thecheckup.org/provider-alerts/  Providers should monitor the Texas Children’s Health Plan 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...

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