HHSC Provider Finance Department will hold its Public Rate Hearing for Medicaid Calendar Fee Reviews, Quarterly Healthcare Common Procedure Coding System (HCPCS), and Medical Policy Reviews on February 3rd, 2023, 9:00 a.m. CST.

Due to the declared state of disaster stemming from COVID-19, this rate hearing will be conducted both in-person and as an online event. To attend this online meeting, please use the following registration link and Webinar ID. After registering, you will receive a confirmation email containing information about joining the webinar.

You can also dial in on your phone using the following phone number and access code. An audio pin will be given at the start of the webinar. Please note, an audio pin is only given to those who answer, and the audio pin must be used to speak with phone audio.

  • Phone number for phone audio: (562) 247-8321
  • Access Code: 411-329-941

Rate Packets Now Available

The rate hearing packets were posted on the HHSC Provider Finance website on January 20, 2023, with proposed effective dates of December 8, 2022, January 1, 2023, and April 1, 2023. The hearing will be for the purpose of receiving public testimony on the following proposed Medicaid Rates.

Proposed to be Effective December 8, 2022

HCPCS Updates:

  • COVID-19 Vaccine Administration Codes

Proposed to be Effective January 1, 2023

Annual HCPCS Updates:

  • HCPCS TOS 1 Drugs
  • HCPCS TOS 1 Non-Drugs
  • HCPCS TOS 2-8 Surgery and Assistant Surgery
  • HCPCS TOS 4 Radiology
  • HCPCS TOS 4 (CT 023) Hospitals
  • HCPCS TOS 5 Clinical Laboratories
  • HCPCS TOS 9, J, L Other Medical Items or Services
  • HCPCS TOS F Ambulatory Surgical Center

Proposed to be Effective April 1, 2023

Medicaid Biennial Review:

  • Long-Acting Reversible Contraceptives (LARCS)

Medical Policy Review:

  • Vendor Drug Program (VDP) Drug Cleanup

Quarterly HCPCS Updates:

  • HCPCS TOS 5 Clinical Labs
  • HCPCS TOS L Durable Medical Equipment Rental

Public Notice and Testimony

The notice for the rate hearing was published in January 13, 2023, issue of the Texas Register, and was posted to the HHSC website on January 4, 2023. Unless otherwise noted in the notice and the rate hearing packets, written comments regarding the proposed payment rates may be submitted instead of, or in addition to, oral testimony until 5:00 p.m. on the day of the hearing. Written comments may be sent by U.S. mail, overnight mail, special delivery mail, fax, or email, as follows:

U.S. Mail:

Texas Health and Human Services Commission

Attention: Provider Finance, Mail Code H-400

P.O. Box 149030

Austin, Texas 78714-9030

Overnight mail or special delivery mail:

Texas Health and Human Services Commission

Attention: Provider Finance, Mail Code H-400

North Austin Complex

4601 Guadalupe St

Austin, Texas 78751

Phone number for package delivery: 512-730-7401

Fax: Attention: Provider Finance at 512-730-7475

Email: PFDAcuteCare@hhs.texas.gov

Persons with disabilities who wish to participate in the hearing and require auxiliary aids or services should contact Provider Finance at (512) 730-7401 at least 72 hours before the hearing so appropriate arrangements can be made.

Preferred Communication

During the current state of disaster due to COVID-19, physical forms of communication are checked with less frequency than during normal business operations. For quickest response, and to help curb the possible transmission of infection, please use email or phone if possible, for communication with HHSC related to this rate hearing.

Please forward this information to providers and organizations in your programs as appropriate. If you have any questions about this rate hearing, please email Provider Finance Acute Care.

Community First Resources:

Community First Contact:

For additional information, please contact Community First Provider Relations at (210) 358-6294 or email ProviderRelations@cfhp.com.

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