Services Submitted with Modifier GZ will be Denied for Texas Medicaid Providers

Date: August 31, 2021 Attention: Primary Care Providers Effective Date: July 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: Effective for dates of service on or after July 1, 2020, claims submitted for services with Modifier GZ for Texas Medicaid will be denied. Services submitted with modifier GZ are not covered and considered not reasonable or necessary. How this impacts providers: This applies to all lines of business and is in alignment with Texas Medicaid and Healthcare Partnership (TMHP) guidance. Affected claims submitted with dates of service from July 1, 2020 forward with modifier GZ, will deny. 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.