Date: March 27, 2025
Attention: Providers
Effective date: April 1, 2025
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers know that effective April 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will add new taxonomy codes for the provider type “allopathic and osteopathic physicians; anesthesia; nutrition specialist.” In addition, the following taxonomy code updates will be made:
| Provider Type | Taxonomy Code |
| Prosthetics Case Management | 1744P3200X – A case manager who provides services for patients with prosthetics. |
How this impacts providers:
New Taxonomy Codes
| Provider Type | Taxonomy Codes | Description |
| Allopathic and osteopathic physicians; anesthesia; nutrition specialist | 207LP4000X | A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, over nutrition, and genetic or acquired errors of metabolism) and adjunctive nutritional therapeutics (e.g., nutritional therapy or support of diseases states with a metabolic component). |
| Allopathic and osteopathic physicians; family medicine; physician nutrition specialist | 207QP0002X | A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, over nutrition, and genetic or acquired errors of metabolism) and adjunctive nutritional therapeutics (e.g., nutritional therapy or support of diseases states with a metabolic component). Physician Nutrition Specialists also provide services for nutritional disease prevention, including diabetes, cancer, Alzheimer’s, hospital malnutrition screening, and perioperative nutrition. |
| Allopathic and osteopathic physicians; anesthesia; physician nutrition specialist | 207RP1002X, 2080P1004X, 2086P0122X | A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, over nutrition, and genetic or acquired errors of metabolism) and adjunctive nutritional therapeutics (e.g., nutritional therapy or support of diseases states with a metabolic component). Physician Nutrition Specialists also provide services for nutritional disease prevention, including diabetes, cancer, Alzheimer’s, hospital malnutrition screening, and perioperative nutrition. |
How this impacts providers: As you may know, Texas Medicaid managed care organizations (MCOs) like TCHP must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO/TCHP. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should reference a member’s specific MCO/TCHP for information on these items. For TCHP, this information can be found on the provider page available here https://www.texaschildrenshealthplan.org/providers.
Next step for Providers: Providers should 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: https://www.texaschildrenshealthplan.org/providers/provider-news/provider-alerts.