Provider Alert! Reimbursement for in-office Durable Medical Equipment and Medical Supplies

Provider Alert!

Provider Alert! Reimbursement for in-office Durable Medical Equipment and Medical Supplies

Date: July 1, 2022

Attention: All Providers  

Effective date: August 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: The purpose of this communication is to clarify the payable Durable Medical Equipment (DME) Codes that physicians are allowed for reimbursement.

DME or medical supply codes on the Physician Fee Schedule can be reimbursed. Codes that are not on the Physician Fee Schedule will not be reimbursed to physicians.

How this impacts providers: Click here for a complete list of the applicable DME and medical supplies.

More information is available here: https://www.tmhp.com/sites/default/files/file-library/resources/provider-manuals/tmppm/pdf-chapters/2022/2022-07-jul/2_DME_and_Supplies.pdf, Texas Medicaid Provider Procedures Manual Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook, 2.4.2 Reimbursement

Next steps for providers: Providers should 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.

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