Additional Procedure Code and Modifier Combinations

Additional Procedure Code and Modifier Combinations will
be added to the Fee Schedules for Some Mental Health
Procedure Codes for Texas Medicaid
Information posted November 26, 2014
Note: This article applies to claims submitted to TMHP for processing. For claims processed by
a Medicaid managed care organization (MCO), providers must refer to the MCO for information
about benefits, limitations, prior authorization, and reimbursement.
Effective December 1, 2014, TMHP will display additional procedure code and modifier
combinations on the Online Fee Look-up (OFL) for some mental health procedure codes.
Providers will be able to view the pricing for several procedure codes and modifier combinations
that were not previously visible on the fee schedules. The static fee schedules will continue to
be updated quarterly. Providers will also be able to view these additions on the Static Fee
Schedule after January 15, 2015.
The following procedure codes will be visible December 1, 2014

Mental Health Procedure Codes updated on the OFL
Note: These additions to the OFL will not affect claims processing.
For more information, call the TMHP Contact Center at 1-800-925-9126.
Mental Health Procedure Codes
Type of
Service
(TOS)*
Procedure
Code
1
H0034
1
H0034
1
H2011
1
H2011
1
H2014
1
H2014
1
Modifier 1
Modifier 2
Age Range
Medicaid Fee Effective
12-1-2014
Adjusted Fee
Percentage
Adjusted Fee
21-999
$13.53
0.00
$13.53
3-20
$13.53
0.00
$13.53
21-999
$36.89
0.00
$36.89
3-20
$36.89
0.00
$36.89
21-999
$25.02
0.00
$25.02
HA
3-20
$25.02
0.00
$25.02
H2017
TD
18-999
$26.93
0.00
$26.93
1
H2017
ET
18-999
$26.93
0.00
$26.93
1
H2017
HQ
18-999
$5.39
0.00
$5.39
TOS*: 1 = Medical Services
HA
HA
TD
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