Texas Medicaid & Healthcare Partnerships (TMHP) posted the following this morning. Please share with appropriate claim staff.
Effective for dates of service on or after August 2, 2016, for services rendered to clients who are dual-eligible for Texas Medicaid and Medicare, procedure code E0248 is now Medicaid-only.
It is not necessary to submit procedure code E0248 to Medicare before it is submitted to Medicaid.
Affected claims with procedure code E0248 with dates of service from August 2, 2016, through April 25, 2017, will be reprocessed. Providers may receive additional payment, which will be reflected on future Remittance and Status (R&S) Reports.
Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details