AAPC - Back to school
Results 1 to 4 of 4

Thread: Texas Medicaid Modifiers

  1. #1

    Default Texas Medicaid Modifiers

    AAPC: Back to School
    Does anyone have links or research sources they could share regarding Tx Medicaid modifiers and any guidelines for assignment/coding.

    Medicaid is a new entity for me; so any resources would be greatly appreciated.

    Thank you

  2. #2

    Default Texas Medicaid


    Go to section 6.3.5 Modifiers. It lists the modifiers and any special instructions.

    hope this helps


  3. #3
    Join Date
    Apr 2007
    Lubbock, TX


    There's also this:

    What I can tell you about them, is that TMHP is weird about modifiers. For example, we bill testing for both A & B strains of influenza; CPT guidelines, and every other payer in the world, instruct us to bill it as :

    But TMHP wants it as:

    Go figure.

    Your best bet is to try to find modifier policies specific to the services you're trying to bill, to figure out what they want you to do. I suggest using a regular search engine to find it (Just type "TMHP coverage..." then your CPT codes and see what you come up with.) It's actually easier to find things that way, than to try to search for them on TMHP's website.

    Once again, go figure. Good luck!

  4. #4

    Default Thank you

    Some light reading for the weekend

    Thank you so much for a great start to research....

Similar Threads

  1. Modifier for 90834/ medicaid of texas
    By driecam@yahoo.com in forum Behavioral Health
    Replies: 2
    Last Post: 03-18-2015, 08:11 AM
  2. Non-Covered by Texas Medicaid
    By Cuteyr in forum Billing/Reimbursement
    Replies: 2
    Last Post: 03-12-2013, 08:43 AM
  3. Texas Medicaid physical
    By Thouvenel in forum Family Practice
    Replies: 0
    Last Post: 10-09-2012, 01:57 PM
  4. Texas Medicaid Modifiers
    By enancy79 in forum Modifiers
    Replies: 0
    Last Post: 08-02-2011, 03:21 PM
  5. Need Help with Texas Medicaid
    By mjones64 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 06-10-2009, 12:01 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.