Preferred lab provider: Quest Diagnostics

As you know, Texas Children’s Health Plan entered into an agreement with Quest Diagnostics to serve as our exclusive reference lab provider, effective January 1, 2015. Per state regulations, laboratory specimens that are required to be sent to state laboratories for processing will continue to follow guidelines provided in the Texas Medicaid Provider Procedures Manual (TMPPM). If you do not currently have a relationship with Quest Diagnostics, you will be contacted by a Texas Children’s Health Plan or Quest Diagnostics representative to discuss how to establish a relationship with Quest. Providers have two options for accessing reference laboratory services:

1. Provider can collect specimens in office and Quest will pick up specimens for testing.
2. Texas Children’s Health Plan members can be sent to Quest Patient Service Centers for specimen collection and testing.

Providers may continue to perform specific lab tests in their office and receive reimbursement from Texas Children’s Health Plan. The list of Physician Office Lab Tests are reimbursable by Texas Children’s Health Plan. All other lab tests must be referred to Quest Diagnostics or State of Texas Laboratories as required in TMPPM. We sincerely appreciate the care and service you provide to our members. For questions or if you need the complete list of lab tests, please contact Provider Relations at 832-828-1008 or toll-free at 1-800-731-8527.