Updates for Bone-Anchored Hearing Device (BAHD) Procedure Codes 92622 and 92623 for Texas Medicaid

Date: June 12, 2024
 
Attention: All Providers

Effective Date: July 1, 2024

Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that on July 1, 2024, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM), Vision and Hearing Services Handbook to move diagnostic analysis procedure codes 92622 and 92623 from section 3.2.1, “Cochlear Implants,” to section 3.2.3, “Bone-Anchored Hearing Device (BAHD).” Procedure codes 92622 and 92623 may be reimbursed for diagnostic analysis of the cochlear implant.

Claims reprocessing:

TMHP has identified an issue that affects claims for procedure codes 92622 and 92623 that were submitted for dates of service on or after January 1, 2024. At this time, age restrictions were removed for procedure codes 92622 and 92623. However, claims may have been denied for clients who are six years of age or younger. 

How this impacts providers:

Affected claims that were submitted with dates of service on or after January 1, 2024, will be reprocessed. Providers may receive additional payment when the claims are reprocessed. Prior authorization is not required.

Next step for Providers:

Providers should share this update with their staff. Refer to Texas Medicaid Provider Procedures Manual (TMPPM) for additional information.

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.