Telemonitoring Benefits to Change for Texas Medicaid March 1, 2021

Date: March 24, 2021 Attention: All Providers Effective Date: March 1, 2021Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to 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: Texas Children’s Health Plan (TCHP) would like to inform network providers of the recent telemonitoring benefits change for Texas Medicaid effective for dates of service on or after March 1, 2021. How this impacts providers: Changes to this medical benefit include the following:

• Effective for dates of service on or after March 1, 2021, the collection and interpretation of a client’s data (procedure code 99091) gathered through home telemonitoring may be a benefit when services are provided by a physician or other qualified healthcare provider in the office and outpatient hospital settings.
• Procedure code 99091 will be limited to once per 30 rolling days.
• Procedure code 99091 replaces codes 99421, 99422, and 99423.
• Effective March 1, 2021, online evaluation and management for home telemonitoring services (procedure codes 99421, 99422, and 99423) will no longer be a benefit.

Resource: Texas Medicaid Provider Procedures Manual Next steps for providers: Providers should share these benefit changes 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.