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December 01, 2022

Long-term services and supports billing changes

Texas STAR+Plus and STAR Kids

Effective Dec.1, 2022, the Texas Health and Human Services Commission (HHSC) will update the long-term services and supports (LTSS) billing matrix for STAR+PLUS and STAR Kids Community Plans.

The updates will affect certain LTSS codes and modifiers, resulting in changes to existing authorizations. To see an updated chart with the appropriate codes and modifiers by service type, please look at the LTSS Codes and Modifiers Guide.

Answering questions

We’re offering virtual training to help you learn more about how these changes may affect how you work with our members. Pick the date(s) and time(s) that work best for you. Sessions are offered Dec. 7, 9 a.m.–10 p.m. and Dec. 13, 9 a.m.–10 p.m. CT.  Learn more about how to sign up for training on our Virtual Training page.

Existing prior authorizations 

To prepare for the changes, existing prior authorizations with the current codes and modifiers will end on Nov. 30, 2022. Effective Dec. 1, 2022, we’ll either add a new service line to the same prior authorization or issue a new prior authorization with the updated codes and modifiers. If we update the existing prior authorization, you’ll see a note in the existing prior authorization that says:

  • Authorizations updated to reflect new code/modifiers effective Dec. 1, 2022, based on the state mandated change 
  • No services have changed because of this update, only the code and/or modifier. Reference previous authorization notes for details. 
  • New HCPC/Service codes and modifiers have been updated to: [Codes and modifiers will be shown]

Resources

View updated prior authorization requests on the UnitedHealthcare Provider Portal > Sign In. Learn more at UHCprovider.com/paan.

If we have not updated your member’s prior authorizations by Dec. 1, 2022, call your provider advocate directly or call provider relations at 888-787-4107.

Send your provider advocate a list of the missing authorizations or email the list to uhc_cp_prov_relations@uhc.com.

Questions?

Please reach out to your provider advocate or call provider relations at 888-787-4107, 8 a.m.– 4 p.m. CT, Monday–Friday.

PCA-1-22-03858-C&S-News_11172022
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