Changes to the STAR Kids LTSS Billing Matrix

Date: August 5, 2022                     Attention: STAR Kids Providers Effective date: December 1, 2022Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 July 14, 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:

• The note at the top of the matrix now states, “MDCP modifier (U6) added to all state plan services to designate MDCP members on encounter claims, with the exception of STAR Health.”
• Updates were made to the following HCPC Codes:

o   Supportive Employment (H2023) o   Employment Assistance (H2025)

• In row 43, Emergency Response Services, Monthly, CFC, and MDCP, the U6 modifier is moved to the second position

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 LTSS Billing Matrix and Crosswalk How this impacts providers: MCOs and MMPs must use the code and modifier combinations without the NCCI-related edits in the LTSS matrices published to the website on April 11, 2022. The STAR Kids, Appendix III, LTSS Billing Matrix and Crosswalk, files have been replaced with a version dated April 2022, effective immediately. MCOs, MMPs, and providers must use the April 2022 matrix until further notice. STAR Kids Handbook Policy Updates: https://www.hhs.texas.gov/handbooks/star-kids-handbook/hhsc-policy-updates Next steps for providers: Providers should share this communication with their staff. Information that was previously published, 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.