Second Quarter National Correct Coding Initiative updates

Call to action: Texas Children’s Health Plan (TCHP) supports the National Correct Coding Initiative (NCCI) updates that are implemented for claims processing by TMHP for Texas Medicaid. How this impacts providers: For Health and Behavior Assessment and Intervention (HBAI), codes 96170 and 96171 will no longer be reimbursed after April 1, 2020. Procedure codes 96167 and 96168 will be the only codes for HBAI, which include the member’s family,  that may be reimbursed when the family member directly participates in the overall care of the member. Next steps for providers: The provider notice is available on the TMHP website. Providers should ensure staff are aware of this guidance. 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.