Date: February 7, 2025
Attention: All Providers
Effective dates: January 1, 2024 and September 1, 2024
Call to action: The purpose of this communication is to inform providers that The Texas Medicaid & Healthcare Partnership (TMHP) made a correction to the Urinary System Surgery and the Physician Administered Drugs – Vaccines & Toxoids spreadsheets.The correction can be found in the article Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Codes Effective January 1, 2024, and September 1, 2024.The affected spreadsheets have been updated and now contain the correct procedure codes and reimbursement information.
Texas Children’s Health Plan (TCHP) will reprocess any impacted claims that are identified. Providers are not required to appeal the claims unless they are denied for additional reasons after reprocessing is completed.
Use the following links to view all the reimbursement rate changes.
Effective for Dates of Service on or After January 1, 2024
Effective for Dates of Service on or After September 1, 2024
- Calendar fee review for:
- Medical policy review for:
- Healthcare Common Procedure Coding System (HCPCS) for:
Next step for providers: Providers should share this communication with their staff.
References:
Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Codes Effective January 1, 2024, and September 1, 2024
If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.
For access to all provider alerts,log into:
www.texaschildrenshealthplan.org/provideralerts.
