Refer to: The CMS website at www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/Categorization_of_Tests.html for information about procedure code and modifier QW requirements.For waived tests, providers must use modifier QW as indicated on the CMS websitePlease...
A review of mental health versus medical/surgical benefits was completed by Community First Health Plans to ensure compliance with the Centers for Medicare & Medicaid Services (CMS) and Texas Health and Human Services Commission rulings regarding Mental Health...
Therapy cost containment notification for Providers and MCOs As required by the 2016-17 General Appropriations Act (GAA), H.B. 1, 84thLegislature, Regular Session, 2015 [Article II, HHSC, Rider 50(c)] (henceforth, Rider 50) the Health and Human Services...
Information posted December 2, 2016Note: This article applies only to claims submitted to TMHP for processing. Refer to the Medicaid managed care organizations (MCOs) for information about MCO benefits, limitations, prior authorization, reimbursement, and MCO specific...
Hearing Aid Fitting and Dispensing Services Billing Changes for Texas Medicaid and the CSHCN Services Program Effective January 1, 2017Effective January 1, 2017, hearing aid fitting and dispensing services can be billed using Audiologist; Otorhinolaryngology Ears,...
Each year, the Texas Diabetes Council (TDC) recognizes Texas HMOs that exceed or are equivalent to the state average for HEDIS performance measures relating to comprehensive diabetes care. According to The Guide to Texas HMO Quality: 2014 (PDF), four HMOs in seven...
