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Bulletins

 

For important announcements from the Texas Health and Human Services Commission, please go to the Provider Information tab.

 

See the bulletins below to stay up-to-date on news, policy changes, and other issues important to your practice.

Billing for Certain CHIP Perinatal Services (PDF 743.47 KB) - 5.30.2018

Fixing Claims Faster Starting June1, 2018 - 5.15.2018

Changes to CHIP Copayments (PDF 406.87 KB) - 5.7.2018 

Billing for Speech Therapy Claims (PDF 276.02 KB) - 4.25.2018 

Claims Rejected by Texas Medicaid & Healthcare Partnership (PDF 763.03 KB) - 4.12.2018 

Prior Authorization for THSteps-CCP Services (PDF 867.08 KB) - 4.3.2018 

Correct Inpatient Bill Type Code Required for Nursing Facility Services (PDF 738.09 KB) - 3.30.2018

Texas Medicaid Enrollment Necessary for Some LTSS Provider Types (PDF 696.51 KB) - 3.28.2018

Submitting Claims for Unlisted Services (PDF 274.07 KB) - 3.22.2018

LTSS Provider Medicaid Enrollment Extended to March 31, 2018 (PDF 92.55 KB) - 3.8.2018

Upcoming Provider Revalidation Webinar on March 22, 2018 - 3.5.2018 

Claims Review Due to Billing Code Changes for Lab Testing (PDF 731.08 KB) - 3.2.2018 

Important Information for Rehabilitation Therapy Providers (PDF 733.5 KB) - 3.2.2018 

Taxonomy Code Requirements for 2018 Claims (PDF 751.81 KB) - 2.26.2018

Claim Adjustments for Rehabilitation Therapy Providers (PDF 733.5 KB) - 2.23.2018

Claims Rejected by Texas Medicaid & Healthcare Partnership (PDF 761.39 KB) - 2.12.2018

Using Modifier 59 When Billing for Distinct Services on the Same Day (PDF 741.03 KB) - 2.12.2018 

Adjustments Complete for Claims Affected by Breastfeeding Support - 1.23.2018

Adjustments Complete for Claims Affected by Benefit Updates for Psychological Neurobehavioral and Neuropsychological Testing - 1.23.2018

New Pediatric Supplement Form Required for Rehabilitation Therapy Authorization Requests (PDF 55.73 KB) - 1.11.2018

Nursing Facility MMP Member Admission Notification (PDF 422.61 KB) - 1.11.2018

Medicaid Fee Changes for Rehabilitation Care Providers (PDF 742.18 KB) - 10.24.2017

Sign Up for Alerts (PDF 729.5 KB) - 10.24.2017 

Help Stop Medicaid Fraud (PDF 132.12 KB) - 10.17.2017 

LTSS Online Authorizaions Updated (PDF 718.91 KB) - 9.27.2017

New Way to Refer for Behavioral Health Needs (PDF 722.54 KB) - 7.20.2017

Important Enrollment Information for Care Providers Ordering, Prescribing or Referring for Our Members (PDF 747.59 KB) - 7.11.2017

Eligibility MESAV Now Available for Nursing Facilities on Link (PDF 58.71 KB) - 6.26.2017

Claim Reconsideration Process Now Available for Clinical Review (PDF 431.5 KB) - 6.22.2017

CHIP Providers Need to be TX Medicaid Enrolled by Dec. 31, 2017 (PDF 53.77 KB) - 6.15.2017

LTSS Providers Need to Enroll in Medicaid by July 1, 2017 (PDF 69.83 KB) - 6.8.2017

A STAR Kids Letter: LTSS Authorizations Extended No Later than June 30, 2017 (PDF 61.32 KB) - 6.6.2017 

Prior Authorization Changes for PT, OT and ST Starting July 1, 2017 (PDF 43.6 KB) - 5.26.2017 - UPDATED

RUG Score Available for Nursing Facilities (PDF 84 KB) - 5.25.2017

Required Taxonomy Billing Deadline Extended to Sept. 1 (PDF 56.1 KB) - 5.16.2017

Texas Health Steps Vaccine Administration Claims Error Resolved (PDF 80.82 KB) - 5.9.2017

Home Health Plan of Care Required for All New Home Health Services Requests (PDF 40.55 KB) - 4.9.2017

Home Health Skilled Nursing Claims Recoupment (PDF 121.75 KB) - 3.29.2017

STAR Kids Prior Authorization Notification (PDF 73.67 KB) - 1.10.2017 | Updated 3.22.2017

Incorrect Payment of STAR Kids Home Health Claims (PDF 41.54 KB) - 03.10.2017

Help Members Get Free Transportation by Enrolling Your Service Location with Medicaid (PDF 750.01 KB) - 02.06.2017

Claims Reprocessing for Incorrectly Paid “Z23 Encounter for Immunizations” Claims (PDF 29.49 KB) - 12.15.2016

Nursing Facility and Home Health Skilled Nursing Claims Alert (PDF 282.82 KB) - 11.8.2016

Outpatient Therapy Prior Authorization Change (PDF 733.49 KB) - 10.7.2016 (updated 10.10.2016)

New Reporting Requirements for Breaches in Confidential Information (PDF 367.49 KB) - 10.6.2016

Help Medicaid members get a ride to your office by enrolling your office location with Medicaid (PDF 61.35 KB) - 9.30.2016

Claims Processing Guidelines (PDF 41.25 KB) - 8.1.2016 

HHSC Alert: MEDsys Providers Must Initiate Transition to DataLogic by July 31, 2018 - 6.5.2018 (PDF 40.71 KB)
HHSC Notice – Data Collection Information for Providers Transitioning to DataLogic Vesta EVV System - 6.04.2018 (PDF 33.99 KB)
HHSC Notice: Order Small Alternative Devices (SAD) Electronically Beginning May 1, 2018 (PDF 19.62 KB) - 5.16.2018
Tour of Texas Info Sessions (PDF 96.57 KB) - 4.25.2018
Transition Timeline EVV (PDF 21.18 KB) - 4.25.2018
HHSC Notice: EVV Cell Phone Policy Alert (PDF 71.82 KB) - 2.9.2018
Small Alternative Devices (SAD) Must Be In Member's Home:  See How To Install - 1.11.2018 

 

HHS Alerts and Resources

Electronic Visit Verification Archives

Reminder on Required EVV System Data Elements - 02.08.2017

HHS Alerts and Resources

Small Alternative Device Zip Tie Now Optional (PDF 158.56 KB) - 5.24.2018

To help with Transition to Vesta: Temporary Reducation for EVV Compliance Rate (PDF 12.65 KB) - 5.22.2018

MEDsys expires Nov. 6, 2018:  What You Need to Know (PDF 172.18 KB) - 3.23.2018
Change to Reason Code 305: Malfunctioning Small Alternative Device or Invalid Small Alternative Device Value - Verified Services Were Delivered - 7.10.2017
Reason Code News - 11.18.2016
HHSC EVV Provider Compliance Plan Notification (PDF 93.25 KB) - 6.1.2016 

Training

Texas Health and Human Services EVV Provider Training - 6.11.2018
2017 Electronic Visit Verification (EVV) Training (PDF 327.4 KB) - 1.20.2017 
Complete List of Reason Codes - 6.11.2018
EVV Brochure (PDF 815.79 KB) - 5.26.2017


Your Plan Compliance

Provider Compliance Plan for UnitedHealthcare Community Plan EVV (PDF 1.22 MB) - 3.15.2017
About The HHSC EVV Provider Compliance Plan Notification (PDF 415.27 KB) - 6.01.2016

2018

Important Reimbursement Reminder for Duplicate or Repeat Services of Global Test Only Codes (PDF 745.19 KB) - 5.30.2018

Reimbursement Notice for Multiple Procedure Reduction Codes (PDF 762.74 KB) - 2.15.2018

Important Reimbursement Change to Ambulance Reimbursement Policy (PDF 747.28 KB) - 1.31.2018 

New Observation Policy (PDF 743.75 KB) - 1.31.2018

2017 

Reimbursement Change for Image Guidance Code 77014 (PDF 68.16 KB) - 12.14.2017

Revenue Codes Requiring Procedure Codes Reimbursement Policy Clarification for Care Providers at Facilities and Hospitals (PDF 66 KB) - Date Posted 12.11.2017 

Ambulance Reimbursement Policy Coding Guidelines Reminder and Policy Changes for 2018 (PDF 57.69 KB) - Date Posted 11.06.2017 

New Add-On Codes Facility Policy - Effective Feb. 1, 2018 (PDF 54.37 KB) - Date Posted 11.06.2017 

Drug Testing Reimbursement Policy Update ‒ Effective Jan. 1, 2018 (PDF 68.64 KB) - Date Posted 10.20.2017

Reimbursement Change for Prolonged Services Policy (PDF 67.23 KB) - Date Posted 8.18.2017

Claim Reprocessing for Rebundling Code 96160 (PDF 48.51 KB) - Date Posted 7.27.2017

New Drug Testing Reimbursement Policy - Effective Sep. 1, 2017 (PDF 50.01 KB) - Date Posted 6.08.2017

Policy Change for the Multiple Procedure Payment Reduction of Diagnostic Imaging Services (PDF 351.3 KB) - Date Posted 4.26.2017

Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy – Acupuncturist Update (PDF 216.94 KB) - Date Posted 4.11.2017

Retirement of Moderate Sedation and Physical Medicine and Rehabilitation: Supervised Modalities Policies, and Changes to Procedure to Modifier and IMRT Policies - Effective May and June 2017 (PDF 202.22 KB) - Date Posted 3.2.2017

New National Drug Code Requirement Policy– Effective May 1, 2017 (PDF 48.37 KB) - Date Posted 1.25.2017                         

2016

Coding Reminder: How to Report Multiple Surgeons For One Operative Session (PDF 366 KB) - Date Posted 11.29.2016                      

Maximum Frequency per Day and Bilateral Procedures  (PDF 110.98 KB) - Date Posted 11.16.2016

Revision to Lupron Policy-Effective January 1, 2017 (PDF 203.22 KB) - Date Posted 9.19.2016

New Facility Reimbursement Policy-Appropriate Patient Status for Type of Bill Policy-Effective December 1, 2016 (PDF 180.99 KB) - Date Posted 8.11.2016

Implementation of the new Clinical Laboratory Improvement Amendments Identification Requirements Policy and the Replacement Codes Policy-Effective August 1 and November 1, 2016. Changes to the Non-Covered Codes, Ambulance, and Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policies-Effective in November and December 2016 (PDF 207.51 KB) - 8.3.2016