23-1, Section 4000 Changes

Revision 23-1; Effective Jan. 5, 2023

The following change(s) were made:

Revised Title Change
4100 General Principles Edits text.
4200 Basic Health Care Services Edits text.
4210 Physician Services Removes information about reducing reimbursement amount for services rendered on or after Feb. 1, 2011.
4211 Annual Physical Examinations Edits text.
4212 Immunizations Edits text.
4213 Medical Screenings Edits text.
4214 Laboratory and X-ray Services Edits text.
4215 Family Planning Services Edits text.
4216 Skilled Nursing Facility Services Adds information on payment rates.
4217 Prescription Drugs Adds new instructions for formulary pricing. Deletes prior pricing instructions.
4218 Rural Health Clinic (RHC) Services Updates link for payment standards.
4219 Inpatient Hospital Services Updates link for payment standards.
4220 Outpatient Hospital Services Updates link for payment standards.
4310 HHSC-Established Optional Health Care Services Updates service list and fee schedules.
4311 Advanced Practice Nurse (APN) Services Updates terminology.
4312 Ambulatory Surgical Center (ASC) Services Updates terminology.
4313 Colostomy Medical Supplies and Equipment Updates terminology.
4314 Counseling Services Updates terminology.
4315 Dental Care Updates terminology.
4316 Diabetic Medical Supplies and Equipment Updates terminology.
4317 Durable Medical Equipment Updates terminology.
4318 Emergency Medical Services Edits text.
4319 Home and Community Health Care Services Edits text.
4320 Physician Assistant (PA) Services Edits text.
4321 Vision Care, Including Eyeglasses Updates terminology.
4322 Federally Qualified Health Center (FQHC) Updates link for payment rates.
4323 Occupational Therapy Services Edits text.
4324 Physical Therapy Services Edits text.
4410 Fee Schedules Updates service table.
4420 Type of Services – Definition and Payment Information Clarifies reimbursement rate for assistant surgical services.