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Static Fee Schedules

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The files on this page contain the Texas Medicaid fee schedules for the selected federal fiscal quarter. These fee schedules provide a view of the fees that were in effect during the first seven days of the selected quarter for the Medicaid program. If you are a Texas Medicaid provider and you have an active account on TMHP.com, you can limit the fee schedules that appear to those that apply to your provider identifier. Click here to log on to your account and select which provider identifier you want to use.

If you do not have an account on TMHP.com, but you know which fee schedules you need, you can select the appropriate Excel or PDF file. If you do not know which fee schedules apply to you, the system can help you find them. Select a provider type and provider specialty from the drop-down menus, and then click Search. The applicable fee schedules will be displayed.

To view past fee schedules, click the archive link at the bottom of the screen.

Multiple worksheets may display results. For more information, please refer to the Help link.

The fee displayed is the allowable rate for this service. Since September 1, 2011, the Online Fee Lookup (OFL) and static fee schedules include a column titled "Adjusted Fee." The Adjusted Fee column displays the fee with all of the percentage reductions applied. The individual provider payment may differ based on provider type, client type program, place of service, or other factors. For additional information about rates, rules, and procedures, providers can refer to the Texas Medicaid Provider Procedures Manual, Texas Medicaid Bulletins, Texas Medicaid website articles, the CSHCN Services Program Provider Manual, CSHCN Services Program website articles, the rate reduction web page at www.tmhp.com/pages/topics/rates.aspx , and other communications from TMHP or state agencies.

Important: The columns listed for the selected procedure code do not include all benefit limitations. Prior authorization may be required for some procedure codes. Other limitations may apply.

Codes that are not a benefit: Any service that is medically necessary to correct or ameliorate a client's physical or mental issues, disability, or chronic condition is a benefit of THSteps when Federal Financial Participation is available, even if the services are not benefits of Texas Medicaid. This expansion of services only applies to clients who are 20 years of age or younger and eligible to receive THSteps services.

Codes that are not listed in the fee schedules may be reimbursed using a contracted rate. Providers may refer to the Contracted Rate search to determine whether the code is a benefit of Texas Medicaid.

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