Effective June 2022: Texas Medicaid Provider Procedures Manual (TMPPM) Updates for Outpatient Drug Services Handbook

May 31, 2022

What is New?

Effective June 2022, the Texas Health and Human Services Commission (HHSC) will remove procedure codes J9219, J9600 and Q0139 from the Outpatient Drug Services Handbook of the Texas Medicaid Provider Procedures Manual (TMPPM). 

Below is a table for details of the change:

Procedure Code

Affected Subsection

Additional Information

J9219

7.57 “Leuprolide Acetate (Lupron Depot)”

Procedure code is not a benefit. All other procedure codes in this subsection remain a benefit of Medicaid

J9600

7.7.16 “Porfimer (Photofrin)”

Procedure code is not a benefit

Q0139

7.53 “Iron Injections”

Refer to the Clinics and Other Outpatient Facility Services Handbook, subsection 6.2.2, “Renal Dialysis Facilities- Consolidated Billing, “for information about procedure code Q0139

Resources

For additional information please reference TMPPM Outpatient Drug Services Handbook.

Questions

For questions or additional information, please:

 

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization. Any questions regarding those organizations should be addressed to them directly. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.