How does reimbursement differ under the Medicaid Women’s Health Program and Titles V and XX?
Services provided under the Medicaid Women’s Health Program are reimbursed according to Medicaid rules at standard Medicaid rates. A list of procedure codes allowed under the WHP is available at www.hhsc.state.tx.us/womenshealth.htm. Reimbursement rates by procedure code are available under the Fee Schedule section of the THMP website, www.tmhp.com. Clean claims will be processed within 30 days. Family planning services provided under Titles V and XX are reimbursed on a fee-for-service basis, up to a total amount specified in the provider’s contract with DSHS. Visit the DSHS website for current reimbursement rates. Contracts are for a defined amount of funding, which may be exhausted before the end of the contract term.
