Rate Changes for Ambulatory Surgical Centers

Date: January 3, 2024

Attention: Ambulatory Surgical Centers (ASCs)

Effective: June 1, 2023

Call to action: Texas Children’s Health Plan (TCHP) would like to notify providers that Texas Health and Human Services Commission (HHSC) revised fee-for-service reimbursement rates for Ambulatory Surgical Centers (ASCs) and Hospital ASCs effective June 1, 2023. These rate revisions shift from the group rate and locality code method of payment for each procedure code and instead assigns fees by procedure code.

How this impacts providers: TCHP is reprocessing affected claims submitted with the date of service on or after June 1, 2023. Additionally, TCHP will not pay interest related to impacted provider claims through December 31, 2023.

Next steps for providers: Providers are encouraged to share this communication with their staff.

If you have any questions, please email Provider Relations at:providerrelations@texaschildrens.org.

For access to all Provider Alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.