Tag - reimbursement

Provider Alert!
15Feb

Provider Alert! Reimbursement Update for Procedure Codes Pending a Rate Hearing

Date: February 14, 2023  Attention: All Providers Effective date: May 8, 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: Beginning May 8, 2023, TCHP will follow the Texas Medicaid Provider Procedures Manual (TMPPM) guidance regarding claims and the procedure codes that are pending a rate...

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Provider Alert!
09Feb

Provider Alert! Orthotics/Prosthetics Services Billed by Podiatrist

Date: February 9, 2023 Attention: Podiatrist Providers Effective date: May 9, 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: Beginning May 9, 2023 and in accordance with Texas Medicaid reimbursement guidelines, TCHP will no longer reimburse podiatry providers for orthotic/prosthetic services. This reimbursement policy aligns...

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Provider Alert!
08Dec

Provider Alert! Inpatient Prepayment Review Program

Date: December 6, 2022 Attention: Hospital Providers and Inpatient 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: The purpose of this communication is to address some of the questions we have been receiving related to prepayment claims reviews.  Texas Children’s Health Plan (TCHP)...

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22Nov

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

Date: November 21, 2022 Attention: All providers Effective Date: October 25, 2022    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...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...
Provider Alert!
06Oct

Provider Alert! Case Management for Children and Pregnant Women (CPW) Carve-In

Date: October 5, 2022 Attention: All Providers Effective date: September 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 purpose of this communication is to inform our providers of the Case Management for Children & Pregnant Women (CPW) carve-in to Medicaid that became...

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Provider Alert!
13Jul

Provider Alert! Update to “Correction to Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Codes”

Date: July 7, 2022 Attention: Behavioral Health Providers Effective date: March 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: Behavioral health providers should note an update in the reimbursement rates for substance abuse disorder codes H0050 and T1007, effective for dates of...

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27Apr

Provider Alert! COVID-19 Procedure Code S8301 Reimbursement Documentation Reminder

Date: April 25, 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to appeal claims unless denied...

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Provider Alert!
18Nov

Provider Alert! JW Modifier Update

Date: November 18, 2021 Attention: All Providers Effective Date: September 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 Texas Medicaid and Healthcare Partnership (TMHP) regarding the reimbursement policy for the unused portion of a single use vial...

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Provider Alert!
02Jul

Provider Alert! Reimbursement and Audit Notification on Surgical Procedure Codes (last updated July 1, 2021)

Date: July 1, 2021 Attention: All Providers Subject: 2021-2022 Reimbursement and Audit Notification on Surgical Procedure Codes (last updated 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: Texas Children’s Health Plan (TCHP) would like to provide information to providers that TCHP follows the...

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Provider Alert!
24Mar

Provider Alert! Update to Renal Dialysis Revenue Codes Eligible for Reimbursement

Date: March 24, 2021 Attention: PCPs and Nephrologists Effective Date: March 23, 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: Texas Children’s Health Plan (TCHP) would like to make network providers aware of updates for some of the renal dialysis revenue codes. How this impacts providers:...

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