Effective May 12, 2023, Texas Health and Human Services Commission (HHSC) and the Texas Medicaid & Healthcare Partnership (TMHP) will no longer waive copayments for Children’s Health Insurance Program (CHIP). We will continue to waive the copayment for mental health and substance use disorder outpatient office visits or COVID-19-related office visits for COVID-19 vaccines, testing and treatment.
What this means
We will no longer cover the amount that would have been paid by the CHIP member through cost-sharing. You will need to collect the appropriate copay amount directly from the member for office visits on or after May 12. The copay amount can be found on the member’s card and is determined based on the member’s income.
Exceptions to the copays
You may not charge copays for mental health and substance use disorder outpatient office visits or COVID-19-related office visits for COVID-19 vaccines, testing and treatment. CHIP copays do not apply to Native Americans, Alaska Natives, CHIP perinate and CHIP perinatal newborn members.
Please adhere to copay guidelines in our Care Provider Manual. If you have any questions, please contact your Provider Advocate or call us at 888-887-9003, 8 a.m.–6 p.m., Monday–Friday.