Update to “Correction to Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Codes”

Date: July 7, 2022 Attention: Behavioral Health Providers Effective date: March 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: Behavioral health providers should note an update in the reimbursement rates for substance abuse disorder codes H0050 and T1007, effective for dates of service on or after March 1, 2022. See table below:

TOS*	Procedure Code	Age Range	Facility (F)	Current Medicaid Fee	Percent Reduction	Current Adjusted Medicaid Fee	Medicaid Fee Effective 3/1/2022	Percent Reduction	Adjusted  Medicaid Fee Effective 3/1/2022
9	H0050	0-999	F	$26.93	0.00%	$26.93	$26.93	0.00%	$26.93
1	T1007	0-999	F	$40.44	0.00%	$40.44	$40.44	0.00%	$40.44
*Type of Service (TOS): 1 = Medical Services

Resources: Health and Human Services (HHS) Provider Finance webpage at https://pfd.hhs.texas.gov/ Rate Packets information is available at https://pfd.hhs.texas.gov/rate-packets Related provider alert: http://www.thecheckup.org/2022/04/06/provider-alert-age-and-diagnosis-restriction-updates-for-drug-procedure-codes-effective-march-1/ How this impacts providers: Any affected claims that are identified will be reprocessed. Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is completed. Next steps for providers: Providers should share this communication with their staff. 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.