UHC reverses incident-to billing policy

HCMS and TMA efforts urging UHC to abandon new restrictions on incident-to billing that became effective May 1, 2021 pay off. UHC announced two new policies as of 8/1/2021 effectively reversing the restriction effective 8/1/2021. 

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FDA authorizes Pfizer COVID-19 booster shot for certain populations

The FDA authorized the Pfizer COVID-19 vaccine booster shot for people 65 and older and adults at risk of severe illness.   The vaccine continues to be available under EUA for individuals 12 through 15 years of age and a third dose for certain immunocompromised patients. The booster shot should be administered at least six months after completion of the primary series.

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TPIs no longer required

Medicaid Texas Provider Identifiers (TPIs) are no longer required effective Sept. 1 for claims, paper prior authorization requests, etc. and are being replaced with the NPI. TPIs will continue to be accepted until Nov. 30, 2021. Thereafter transactions with TPIs will be rejected.  

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PMP licensing fee no longer covered by the state

 Effective Sept. 1, 2021, the PMP licensing fee is no longer covered by the state, and Apriss, the state's PMP vendor, has begun billing physicians for that fee.  The TMA continues to work with the state to find a way to defray the cost; however, at this time, funding has not been made available.  For questions, contact the TMA Knowledge Center at (800) 880-7955.

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