After hours Codes Reminder

Date: May 14, 2021Attention: PCPs and Urgent Care FacilitiesProviders 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 Procedure Codes: 99050 - Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (e.g., holidays, Saturday or Sunday), in addition to basic service 99056 - Service(s) typically provided in the office, provided out of the office at request of patient, in addition to basic service 99060 - Service(s) provided on an emergency basis, out of the office, which disrupts other scheduled office services, in addition to basic service 99051 – is a non-Medicaid payable code Next steps for providers: Providers should share this guidance with their office 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.