June 20, 2022

Texas Medicaid: Changes to CHIP copayments for mental health and substance use disorder services

Effective July 1, 2022, Texas Health and Human Services (HHSC) is prohibiting copayments for Children’s Health Insurance Program (CHIP) Mental Health and Substance Use Disorder (MH/SUD) outpatient office visits, inpatient services and residential treatment services. This prohibition is not contingent on the COVID-19 national public health emergency.

Under the new prohibition:

  • We will continue to reimburse providers for copayments not collected from members 
  • Moving forward, please use the attestation form to attest that the medical office visit copayment was not collected 
  • We will reimburse you the full rate for the service, including what would have been paid by the member through cost-sharing

Revised process  
The HHSC attestation form  doesn’t need to be submitted with a claim. However, the attestation form, which documents that a co-pay wasn’t collected from the member, should be completed by the provider and kept in the member’s file.

Questions? 
If you have questions, call your provider advocate or UnitedHealthcare Community Plan of Texas customer service at 888-887-9003, 8 a.m.–6 p.m. CT, Monday–Friday.

You can also visit UHCprovider.com/claims for more information.

PCA-1-22-01960-C&S-News