You may begin collecting CHIP COVID-19 co-pays on October 1, 2024.
During the COVID-19 public health emergency, the Texas Health and Human Services Commission waived co-pays for COVID-19 vaccines, testing, and treatment for Children’s Health Insurance Program members. This waiver will end on September 30, 2024.
For CHIP COVID-19 vaccines, testing, and treatment scheduled on or after October 1, 2024, you may begin collecting co-pays.
CHIP co-pays that members must pay are determined based on their income. CHIP co-pays do not apply to Native Americans, Alaska Natives, CHIP Perinate and CHIP Perinatal newborn members.
Providers must adhere to co-pay guidelines outlined in our Texas Medicaid Provider Manual.
Reminder you may not charge co-pays for mental health and substance use disorder outpatient office visits.
Co-pays have been permanently removed for mental health and substance use disorder outpatient office visits to comply with federal regulations.
Questions
Providers, for questions or additional information, please:
- Contact your Medicaid Network Representative at 1-855-212-1615
- Submit via email Texas Medicaid Network Department
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.