Provider Type and Places of Service Update for Procedure Code 96372

Date: February 1, 2024

Attention: All Providers

Effective date: January 1, 2024

Call to action: Texas Children’s Health plan (TCHP) would like to make providers aware that effective for dates of service on or after January 1, 2024, injectable medication administration procedure code 96372 may be reimbursed to Texas Health Steps medical providers for services rendered in the office, outpatient hospital and birthing center settings.

Next step for Providers: Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete. Providers may bill TCHP retroactively for procedure codes 96372, and related medication administration procedure codes.

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.