Case Management for Children and Pregnant Women COVID-19 Flexibilities

Date: 02/13/23

In response to the COVID-19 Public Health Emergency (PHE), Texas Health and Human Services Commission (HHSC) has allowed Case Management for Children and Pregnant Women (CPW) services for Superior HealthPlan Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) members since April 1, 2020, including comprehensive visits, to be completed by telephone (audio-only telecommunications). This flexibility will remain in place until HHSC provides further direction.

Effective September 1, 2022, CPW comprehensive visits and follow-up visits, completed using synchronous audiovisual technology, is a benefit of Texas Medicaid.

Please reference the key details below of existing CPW COVID-19 flexibilities in effect, including an updated coding requirement that aligns with national correct coding practices:

• CPW services, including comprehensive visits, may be completed by telephone (audio-only telecommunications).
• Modifier 93 must be included on the claim form when the comprehensive visit or follow-up visit is completed using telephone (audio-only) telecommunications.

For any questions, please contact your local Account Manager.