Effective September 1, 2025, updates to the Texas Medicaid reimbursement structure will impact base wage requirements for Community First Health Plans’ Long-Term Services and Supports (LTSS) Providers. These changes are part of the implementation of the Patient-Driven...
Provider News
Upcoming Updates to STAR+PLUS Billing Codes and Modifiers: Transition to PDPM LTC Model
Effective September 1, 2025, the Texas Health and Human Services Commission (HHSC) will implement updates to billing codes and modifiers for Long-Term Services and Supports (LTSS) delivered through the STAR+PLUS Home and Community-Based Services (HCBS) program. These...
Prior Authorizations Extended for Services Impacted by 2025 Texas Flooding
UPDATED 9/3/2025: This news post has been edited to reflect updated guidance from HHSC. The information below applies to all Texas Medicaid clients impacted by the 2025 Texas flooding regardless of whether the clients are permanent residents of a declared disaster...
Rider 32 Update: EVV Required for Medicaid-Only Services for Dual Eligible Members
Beginning Sept. 1, the Texas Health and Human Services Commission (HHSC) will transition Medicaid-only services for dually eligible clients (clients who are eligible for both Medicare and Medicaid) enrolled in Medicaid managed care from a fee-for-service (FFS) to a...
Payspan Portal Production Maintenance – Saturday, August 16, 5:00 P.M. (ET) through 8:00 P.M. (ET)
Dear Valued Zelis® Customer: Zelis® is utilizing a maintenance window for the Payspan Portal from 5:00 P.M. (ET) – 8:00 P.M. (ET) on Saturday, August 16, 2025. Note: We will end the maintenance early if the activities are completed by 8:00 P.M....
THSteps Newborn Screening – Key Reminders for Providers
Community First Health Plans would like to remind providers of the THSteps newborn screening requirements and related billing guidance for Medicaid-enrolled infants. Under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), newborn screenings are a...
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