Tag - Procedure Codes

Provider Alert! Date: Temporary Flexibilities for Nutritional Counseling and Texas Health Steps (THSteps) Checkups Will End When Public Health Emergency Ends

table { border-collapse: collapse; }tr,td { border: solid thin; } Date: May 5, 2022 Attention: All Providers 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: The purpose of this communication is to inform providers of the upcoming changes for the temporary flexibilities that have been [...]

Provider Alert!

Provider Alert! Age and Diagnosis Restriction Updates for Drug Procedure Codes, Effective March 1

Date: April 6, 2022 Attention: Providers Effective Date: March 1, 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: On March 1, 2022, HHSC updated age and diagnosis restrictions for drug procedure codes J0596, J0598, J0599, and J9348 for Medicaid and CHIP. Fee-for-service criteria for [...]

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Provider Alert! Date: Pneumococcal Vaccine Procedure Codes 90671 and 90677 Become Benefits of Texas Medicaid

Date: January 13, 2022 Attention: Primary Care Providers Effective Date: March 1, 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: The U.S. Food and Drug Administration (FDA) approved the use of PREVNAR 20 (procedure code 90677) on June 10, 2021 and the use of [...]

Provider Alert!

Provider Alert! Updates for Prostate Surgeries Procedure Codes

Date: August 24, 2021 Attention: Urologists Effective Date: October 1, 2021 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: Effective for dates of service on or after October 1, 2021, reimbursement rate updates for Prostate Surgeries procedure codes will be implemented. How this impacts providers: The [...]

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Provider Alert! New Procedure Codes Available for Evoked Response Tests and Neuromuscular 

Date: July 28, 2021 Attention: Audiologists, Radiologists, DME, and Lab Providers Effective Date: July 1, 2021 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: Beginning July 1, 2021, Healthcare Common Procedure Coding System (HCPCS) procedure codes 92652 and 92653 (for evoked response tests and neuromuscular), [...]

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Provider Alert! After hours Codes Reminder

Date: May 14, 2021 Attention: PCPs and Urgent Care Facilities 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 would like to remind providers of Medicaid After-Hours Procedure Codes that do not require prior authorization. How this impacts providers: Below are the Medicaid Payable After-Hours [...]

Provider Alert! COVID-19 Procedure Codes for the Introduction of Infusion of Therapeutics

Date: January 6, 2021 Attention: All Providers Effective Date: For dates of service on or after August 1, 2020 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’s Health Plan (TCHP) aligns with the Centers for Medicare & Medicaid Services (CMS) in response to [...]

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Provider Alert! Second Quarter 2020 HCPCS Updates for Texas Medicaid

table { border-collapse: collapse; }tr,td { border: solid thin; } Attention: All Providers Effective Date: July 1, 2020 Updated September 10, 2020 Call to action: Texas Children’s Health Plan (TCHP) aligns with the Healthcare Common Procedure Coding System (HCPCS) additions, revisions, and discontinuations that are implemented for claims processing by TMHP for Texas Medicaid. How this impacts providers: Second Quarter 2020 HCPCS Added Procedure Codes are as follows: Clinician Administered Drug (CAD) Procedure Codes C9061 J0223 J0691* J0742 J0791* (replacing C9053) J0896  J7169* J7204 J9177 J9246 J9358 Q5119 Q5120     The follow codes have age restrictions: J1201 – 6 [...]

Telehealth Benefits to Change for Texas Medicaid June 1, 2017

Information posted April 14, 2017 Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details. Effective for dates of service on or after June 1, 2017, telehealth benefits will change for Texas Medicaid. Overview of Benefit Changes Major changes to this [...]