You should have received a Batch ID if you performed a search for:
- 11 to 50 procedure codes.
- A range of procedure codes.
- All procedure codes that apply to a provider identifier or provider type and specialty.
Enter your batch ID number in the Batch ID field below, and click
Search.
Batch results are available within 36 hours of submission.
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
https://www.tmhp.com/resources/rate-and-code-updates/rate-changes,
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.