Update to Therapeutic Optometry Billing Services for CPT Code 65778

Date: January 12, 2023

Attention: Therapeutic Optometrists

Effective: April 11, 2024

Call to action: Effective for dates of service on or after April 11, 2024, therapeutic optometrists are to bill with taxonomy code 152WV0400X (optometry vision therapy) when billing for placement of amniotic membrane on the ocular surface; without sutures, CPT code 65778.

Next steps for providers: Providers should verify they are enrolled through Texas Medicaid & Healthcare Partnership (TMHP) under the therapeutic optometry taxonomy with code 152WV0400X in order for claims to process correctly after April 11, 2024. For information on TMHP Provider Enrollment and Management System (PEMS), visit https://www.tmhp.com/topics/provider-enrollment.

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.