Review these alerts and bulletins to stay up to date on news, policy changes and other issues important to your practice.
For important announcements from the Texas Health and Human Services Commission, visit the Messages from Texas HHSC page.
- 11.13.2019 - Coordination of Benefits and Prior Authorizations
- 11.13.2019 - Home and Community-Based Services: Making the Most for Members
- 11.12.2019 - Specialty Therapies: PTOTST New Prior Authorization FAQs
- 11.05.2019 - New Pharmacy Prior Authorization Requirements - Beginning Dec. 15, 2019
- 10.28.2019 - New Pharmacy Prior Authorization Requirements - Beginning Dec. 1, 2019
- 10.15.2019 - UPDATED! Oct. 25, 2019 - Outpatient Special Therapy Provider Training
- 10.04.2019 - Delays Due to Tropical Storm Imelda
- 09.30.2019 - Prior Authorization Policy Change for Speech, Occupational, and Physical Therapy Services Begin Nov. 1, 2019
- 09.30.2019 - Change for Requesting Some PTOTST Services Begin Nov. 1, 2019
- 09.25.2019 - Open Enrollment for Attendant Compensation Rate Enhancement
- 09.25.2019 - Enroll All Service Locations for Texas Medicaid Transportation
- 09.18.2019 - Update to STAR+PLUS Long-Term Services and supports Billing Matrix
- 08.26.2019 - Provider Statement of Need Requirement Delayed
- 08.22.2019 - New Prior Authorization Requirements for Certain Prescriptions - Effective Oct. 1, 2019
- 08.16.2019 - DUR Educational Newsletter: Opioid and Buprenorphine Use for Treating Opioid Use Disorder
- 08.02.2019 - New Prior Authorization Requirements for Certain Prescriptions - Effective Sept. 1, 2019
- 07.17.2019 - We Welcome Your Feedback: Lookout for the Provider Satisfaction Survey!
- 07.17.2019 - Wait List Reporting for Physical, Occupational, and Speech Therapy Providers
- 07.09.2019 - Electronic Visit Verification Transaction Review Update - Effective July 15, 2019
- 06.20.2019 - Outpatient Care Service Claims Processing for STAR+PLUS Members with Medicare Benefits
- 06.20.2019 - Exceptions for Outpatient Care Service Claims for STAR+PLUS Members with Medicare Benefits
- 06.05.2019 - Therapy Authorization Clarification: Requesting Overlapping Periods
- 05.24.2019 - Use claimsLink to Manage Claims
- 05.17.2019 - Meet Us at a Provider Information Expo in Texas
- 05.15.2019 - Billing NPI with Services Delivered in the Community
- 05.07.2019 - Incorrect Payment of Voided Claims
- 05.02.2019 - Update to Inpatient Acute Care Claims Processing for STAR+PLUS Members Who Also Have Medicare Benefits
- 04.15.2019 - Claims Reconsiderations and Appeals
- 04.12.2019 - Provider Alert: Update to UnitedHealthcare Dual Complete Claims Processing
- 03.19.2019 - Services Ordered By A Court of Law
- 03.19.2019 - Writing Functional Therapy Goals Q&A Now
- 03.08.2019 - Billing Provider Taxonomy Now Required on All Claims
- 03.08.2019 - NPI Not Required on Claims for PTOTST Services
- 03.08.2019 - Federally Qualified Health Centers Encounter Rate Just Got Easier
- 02.11.2019 - claimsLink Enhancements – New Search Options and Claims Information
- 12.31.2018 - Care Provider Directory Update: Area of Expertise
- 12.10.2018 - Wait List Reporting for Physical, Occupational and Speech Therapy Providers
- 11.21.2018 - Professional Claims Billing Providers to Use Qualifiers with Taxonomy
- 11.16.2018 - Provider Alert: NPI Number Required for Physical, Occupational and Speech Therapy (PTOTST) Provider Claims Starting February 1, 2019
- 11.08.2018 - Provider Alert: Updated Abuse, Neglect and Exploitation Reporting Process for STAR Kids Care Providers
- 11.05.2018 - Prior Authorization for Post-Acute Inpatient Care Required for Medicare Advantage Benefit Plans - Effective January 1, 2019
- 11.05.2018 - UnitedHealthcare Community Plan Outpatient Injectable Cancer Therapy Authorization Process Changes - Effective February 1, 2019
- 11.01.2018 - Update to Multiple Procedure Payment Reduction Policy
- 11.01.2018 - New Vitamin D Policy for Texas - Effective January 18, 2019
- 09.26.2018 - Wellness Quality Measures Observation and Documentation
- 09.24.2018 - New Prior Authorization Requirements for Parsabiv
- 09.04.2018 - Respite Prior Authorization Requests for STAR+PLUS Waiver Members
- 08.28.2018 - Provider Alert: Incorrectly Paid Claims for Non-Emergent Ambulance Transportation for STAR+PLUS Members Who Also Have Medicare Benefits
- 08.14.2018 - New Smart Edits for Care Provider Taxonomy Starting August 16, 2018
- 08.10.2018 - Provider Alert: Billing Care Provider Taxonomy Necessary on Claims Starting September 1, 2018
- 08.09.2018 - Necessary Neonatal Level of Care Designation
- 08.08.2018 - Facility Billing Codes: When to Send the Bill to Us
- 07.23.2018 - Home Nursing Services: Acute and LTSS; S and G Codes
- 07.23.2018 - Provider Alert: Incorrect Payment of Personal Care Services Claims
- 06.29.2018 - Important Claims Changes for Texas Medicaid Care Providers
- 06.20.2018 - Updated Policy: Provider Statement of Need Required for PCS and HAB Services Prior to Authorization of Services
- 05.30.2018 - Billing for Certain CHIP Perinatal Services
- 05.15.2018 - Fixing Claims Faster Starting June 1, 2018
- 05.07.2018 - Changes to CHIP Copayments
- 06.22.2018 - Billing for Speech Therapy Claims
- 04.12.2018 - Claims Rejected by Texas Medicaid & Healthcare Partnership
- 04.03.2018 - Prior Authorization for THSteps-CCP Services
- 03.30.2018 - Correct Inpatient Bill Type Code Required for Nursing Facility Services
- 03.28.2018 - Texas Medicaid Enrollment Necessary for Some LTSS Provider Types
- 03.22.2018 - Submitting Claims for Unlisted Services
- 03.08.2018 - LTSS Provider Medicaid Enrollment Extended to March 31, 2018
- 03.05.2018 - Upcoming Provider Revalidation Webinar on March 22, 2018
- 03.02.2018 - Claims Review Due to Billing Code Changes for Lab Testing
- 03.02.2018 - Important Information for Rehabilitation Therapy Providers
- 02.26.2018 - Taxonomy Code Requirements for 2018 Claims
- 02.23.2018 - Claim Adjustments for Rehabilitation Therapy Providers
- 02.12.2018 - Claims Rejected by Texas Medicaid & Healthcare Partnership
- 02.12.2018 - Using Modifier 59 When Billing for Distinct Services on the Same Day
- 01.23.2018 - Adjustments Complete for Claims Affected by Breastfeeding Support
- 01.23.2018 - Adjustments Complete for Claims Affected by Benefit Updates for Psychological Neurobehavioral and Neuropsychological Testing
- 01.11.2018 - New Pediatric Supplement Form Required for Rehabilitation Therapy Authorization Requests
- 01.11.2018 - Nursing Facility MMP Member Admission Notification
- 10.17.2017 - Help Stop Medicaid Fraud
- 05.25.2017 - RUG Score Available for Nursing Facilities
You can find more information on Electronic Visit Verification including alerts, resources, training, and policies by visitng the EVV webpage or by navigating to "Electronic Visit Verification (EVV)" on the left sidebar.
EVV training can also be found on the Training and Education page.
- 09.10.2019 - Claims Clarification: Microbiology Billing
- 07.26.2019 - Authorization Clarification: Therapy for Medicare-Medicaid Plan
- 07.12.2019 - (For 016151) Claims Clarification: Behavioral Health Case Management
- 07.12.2019 - (For 016184) Claims Clarification: Early Childhood Intervention, Case Management and Specialized Skills Training
- 07.02.2019 - Claims Clarification: Therapy Authorizations
- 06.13.2019 - Claims Clarification: Dental Procedures Completed in a Medical Facility
- 05.30.2019 - Claims Clarification: Clinician Administered Drug Billing and Diagnosis Codes
- 05.29.2019 - Claims Clarification: 12 Hour Daily Limit
- 05.29.2019 - Claims Clarification: Behavioral Health Evaluations and Therapies
- 05.29.2019 - Claims Clarification: Psychological, Neurobehavioral and Neuropsychological Testing
- 05.06.2019 - Claims Clarification: Therapy Evaluation and Reevaluation
- 03.21.2019 - Claims Clarification: Billing for Certain Vitamins and Minerals for Members Ages 20 and Younger
- 03.07.2019 - Ambulatory EEG Claims Require Certain Diagnosis Codes
- 03.07.2019 - Ambulance Emergency Codes Need ET Modifier
- 03.07.2019 - Private Duty Nurses Use UA modifier for Specialized Services for STAR KIDS, STAR and CHIP Members
- 02.05.2019 - Claims Clarification: All Ambulance Transportation Claims for STAR+PLUS Members who also have Medicare Benefits
- 01.25.2019 - Claims Clarification: Private Duty Nursing Diagnosis Codes for Special Services
- 01.08.2019 - Claims Clarification: Prosthetic and Orthotic Billing Codes for STAR+PLUS Members
- 12.18.2018 - Claims Considerations: Prescribed Pediatric Extended Care Centers Daily Billing
- 12.07.2018 - Claims Clarification. CHIP Wellness
- 12.04.2018 - Claims Clarification. THSteps Medical Checkups
- 12.03.2018 - Claims Clarification: Adult Preventive Checkups
- 12.03.2018 - Claims Clarification: Corrected Claims
- 10.12.2018 - Claims Clarification: Ambulance Wait Times
- 10.12.2018 - Claims Clarification: Outpatient Facility Observation Claims
- 09.28.2018 - Claims Clarification: Occupational Therapy/Physical Therapy/Speech Therapy Rehabilitation Claims
- 08.28.2018 - Claims Clarification: Non-Emergent Ambulance Transportation Claims for STAR+PLUS Members Who Also Have Medicare Benefits
- 07.23.2018 - Ambulance: Supplies; Attendant: Condition
- 07.23.2018 - Rehab Therapies: Untimed Therapies; Restricted Codes
For Medical Policies, Medical Benefit Drug Policies, Coverage Determination Guidelines, Utilization Review Guidelines and corresponding update bulletins for UnitedHealthcare Community Plan, visit the Policies and Protocols section.