Update to the Long-Term Services and Supports Billing Matrix and Crosswalk

Date: July 28, 2023
 
Attention: STAR kids Providers

Billing matrix has been updated effective: July 7, 2023

Call to action: The purpose of this communication is to inform providers of updates made to the LTSS billing matrix effective July 7, 2023.

Description of the updates:  

• Health and Human Services Commission (HHSC) added language to clarify that the U6 modifier must be added to all prior authorizations and encounter claims for state plan LTSS for members in the Medically Dependent Children Program (MDCP)
• HHSC also made corrections to the revenue codes listed for HCPCS code S5151 (Out-of-Home Respite (Facility)). HCPCS code S5151 must be billed as a per diem rate using revenue code 663.

Resource: Appendix III, LTSS Billing Matrix and Crosswalk.

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

Information that we previously published:

http://www.thecheckup.org/2023/05/09/provider-alert-changes-to-the-long-term-services-and-supports-billing-matrix-and-crosswalk/

http://www.thecheckup.org/2022/10/27/provider-alert-changes-to-the-star-kids-ltss-billing-matrix-and-crosswalk-effective-december-1-2022-2/

http://www.thecheckup.org/2022/10/12/provider-alert-changes-to-the-star-kids-ltss-billing-matrix-and-crosswalk-effective-december-1-2022/

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 Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.