Texas Medicaid &Healthcare Partnership (TMHP) has compiled a list of primary care physicians eligible for the temporary fee increase
for treating Medicaid patients that was authorized by the Affordable Care Act. On the list are the names of physicians who filed the required form by Oct. 16, attesting
that they are eligible for the increase.
TMHP if you submitted an attestation form but your name
is not on the list or if the information is incorrect.
health reform law grants a rate increase for certain primary care providers and
services from Jan. 1, 2013, through Dec. 31, 2014. Physicians must self-attest either that they are board certified in family medicine, general internal medicine, pediatric
medicine or a subspecialist within those designations as recognized by the
American Board of Medical Specialties, the American Osteopathic Association, or
the American Board of Physician Specialties, or that 60 percent of their Medicaid
billings for the prior year were for certain evaluation and management (E&M) services. Those services include E&M codes 99201 through 99499 and
services related to the administration of vaccines (90465, 90466, 90467, 90468,
90471, 90472, 90473, and 90474).
state plans to begin paying the rate increase as a supplemental quarterly payment
for services rendered in January for Medicaid managed care and in April for
Medicaid fee-for-service. Retrospective payments will be issued to Jan. 1, 2013,
for physicians who self-attest between Jan. 1, 2013, and April 1, 2014. Physicians
who wait until after April 1, 2014, to self-attest will qualify only for
supplemental payments back to the date their attestation form was
physicians must self-attest by completing the Texas Medicaid Attestation for ACA Primary Care Services Rate Increase form.
Action, Dec. 4, 2013