Attention Community First Providers:
You may begin collecting CHIP copays on May 12, 2023.
During the COVID-19 public health emergency, the Texas Health and Human Services Commission (HHSC) waived copays for Children’s Health Insurance Program (CHIP) medical office visits. This waiver will end on May 11, 2023.
For CHIP medical office visits scheduled on or after May 12, 2023, you may begin collecting copays. You may not charge copays for the following:
- COVID-19-related office visits for COVID-19 vaccines, testing, and treatment, including preventative therapies and treatment of post-COVID conditions (long-haul COVID-19), and treatment of health conditions that may seriously complicate the treatment of COVID-19 during the period when a patient is diagnosed with or is presumed to have COVID-19.
- Mental health and substance use disorder outpatient office visits. Co-pays have been permanently removed for mental health and substance use disorder outpatient office visits to comply with federal regulations.
Copays are not required for covered services delivered via telemedicine or telehealth to CHIP members.
CHIP copays that Members must pay are determined based on their income. CHIP copays do not apply to Native Americans, Alaska Natives, CHIP Perinate and CHIP Perinatal newborn members.
Providers must adhere to copay guidelines outlined in the Community First Health Plans CHIP Provider Manual. If you have any questions, please contact Provider Relations at 210-358-6294 or email ProviderRelations@cfhp.com.