To: All Texas Children’s Health Plan Providers
Subject: Annual Reminder on Copayments and Deductibles
Texas Children’s Health Plan will pay for a primary insurance deductible with proof of assignment to the deductible on the primary evidence of procedure. Payments will be made up to Medicaid allowable only.
Claims for primary insurance copayments should be sent to Texas Medicaid and Healthcare Partnership directly. Texas Children’s Health Plan will not pay CP001 or CP002 on a claim as these are not payable by the managed care organization per the Texas Medicaid Program.
Providers seeking reimbursement on these codes will need to submit the claim to Texas Medicaid and Healthcare Partnership, per section 6.12.2.2 of the Texas Medicaid and Healthcare Partnership Provider Manual.
If you have any questions please contact your Provider Relations Manager at 832-828-1008 or toll free 1-800-731-8527.