Provider Alert! Changes to the STAR Kids LTSS Billing Matrix and Crosswalk Effective December 1, 2022

Date: October 12, 2022

Attention: All Providers

Effective Date: December 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:

UPDATE October 10, 2022: On June 1, 2022, the Health and Human Services Commission (HHSC) comprehensively revised the Long-Term Services and Supports (LTSS) Billing Matrices and incorporated National Correct Coding Initiative (NCCI)-related revisions.

The changes for STAR Kids/STAR Health include the following:

• A new row 1 containing a revision date was added to the matrix.
• Row 2 was amended to read, “*All services and HCPCS codes are applicable to STAR Health. Modifiers do not apply to STAR Health.”
• A new row was added for T2002 with a U6 modifier with description that reads, “Prescribed Pediatric Extended Care transportation (MDCP)”
• Row 37 in the “Summary of Changes” tab was amended to read, “Updated to CFC / MDCP only as this is paid through CFC”

Texas Children’s Health Plan (TCHP) would like to remind providers of the effective date of December 1, 2022, for the revised LTSS billing matrix. STAR Kids Handbook Appendix III, STAR Kids LTSS Billing Matrix and Crosswalk: https://www.hhs.texas.gov/handbooks/star-kids-handbook/appendix-iii-ltss-billing-matrix-crosswalk

How this impacts providers: As a reminder, prior authorizations must be submitted using new codes and modifiers beginning October 17, 2022, for services effective on or after December 1, 2022. Prior authorizations for services on or after December 1, 2022, using old codes and modifiers will not be accepted.

Next steps for providers: Providers are encouraged to share this communication with their staff.

Information that was previously published, http://www.thecheckup.org/2022/08/08/provider-alert-changes-to-the-star-kids-ltss-billing-matrix/

http://www.thecheckup.org/2022/06/13/provider-alert-clarification-for-the-star-kids-ltss-billing-matrix-revisions-2/

http://www.thecheckup.org/2022/04/20/provider-alert-star-kids-long-term-services-and-supports-billing-matrix-revisions/.

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