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Surgical Services Procedure Code 45399 to Become a Benefit of Texas Medicaid

Date: September 12, 2024 

Attention: All Providers 

Subject: Surgical Services Procedure Code 45399 to Become a Benefit of Texas Medicaid

Effective date: October 1, 2024

Call to action: Texas Children’s Health Plan (TCHP) would like to inform network providers that effective for dates of service on or after October 1, 2024, procedure code 45399 for surgical services for unlisted procedure, colon will become a benefit of Texas Medicaid.

How this impacts providers: Procedure code 45399 may be reimbursed for the following providers and service locations:

  • Physicians for services rendered in the hospital setting
  • Ambulatory surgical center providers and hospital-based ambulatory surgical centers in the outpatient hospital setting

TCHP does not require prior authorization for procedure code 45399.

Next step for providers: Providers should share this update 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.texaschildrenshealthplan.org/providers/provider-news/provider-alerts.