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.
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]