Methodology / Rules
The Physician Services program rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter A, Division 5, Rules 1061-1062.
Reimbursement rules applicable to Physician Services are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter J, Division 3, Rule 8041 and Division 5, Rule 8085.
The fee schedules and any periodic adjustment(s) to the fee schedules are published in banner messages contained in provider Remittance and Status (R&S) reports, Medicaid Bulletin articles, web postings, provider manual, fee schedules or other provider notification.
Payment Rate Information
Payment rate information is published by procedure code in the applicable Texas Medicaid Fee Schedule located on the Texas Medicaid & Healthcare Partnership (TMHP) website (see Fee Schedules).