Changes and Updates to the Long Term Services and Supports (LTSS) Billing Maxtrix and Crosswalk

07/31/2023

What’s new

Effective July 7, 2023, the Texas Health and Human Services (HHSC) posted a notification, stating upcoming changes to the STAR Kids Handbook, Appendix III, Long-term Services Supports (LTSS) Billing Matrix and Crosswalk.

Blue Cross and Blue Shield of Texas (BCBSTX) Providers please ensure you are using the most updated version (effective July 7, 2023). The changes included:

  • HHSC added language to clarify that the U6 modifier must be added to all prior authorizations and encounter claims for state plan LTSS for members in the Medically Dependent Children Program (MDCP).
  • HHSC also made corrections to the revenue codes listed for HCPCS code S5151 (Out-of-Home Respite (Facility)). MCOs must ensure that S5151 is billed as a per diem rate using revenue code 663.

Resources:  Appendix III, LTSS Billing Matrix and Crosswalk

If any questions, please contact BCBSTX EVV email at: BCBSTX_EVV_Questions@bcbstx.com