Provider News
Implant Billing and Reimbursement Guidelines for Inpatient and Outpatient Services
Community First Health Plans is providing guidance on billing and reimbursement requirements for implantable devices for both inpatient and outpatient hospital services. Proper coding and documentation are required to ensure accurate claims processing and to avoid...
Wheeled Mobility Systems: QRP Seating Assessment and Billing Guidance
Community First Health Plans is providing guidance on billing requirements for services performed by a Qualified Rehabilitation Provider (QRP) related to wheeled mobility system and wheelchair seating assessments and fittings. Proper adherence to these billing...
Emergency Preparedness for Hurricane Season: HHSC Provider Guidance
Community First Health Plans is sharing guidance from the Texas Health and Human Services Commission (HHSC) regarding emergency preparedness for the Atlantic hurricane season, which runs from June 1 through November 30. Providers are encouraged to review and update...
Modifier 25: Correct Use and Coding Guidance for Preventive and Acute Care Services
Community First Health Plans is providing guidance on the appropriate use of Modifier 25 when reporting evaluation and management (E/M) services performed on the same date as a preventive medical visit. Proper use of Modifier 25 supports accurate claims processing,...
Modifier 26: Correct Use and Coding Guidance for Diagnostic Services (Professional Component)
Community First Health Plans is providing guidance on the appropriate use of Modifier 26 (Professional Component) when billing for diagnostic services. Proper use of Modifier 26 supports accurate claims processing, compliance with CMS billing guidelines, and reduces...
Important: New TMHP Login Process for All Texas Medicaid Providers – Action Required
Community First Health Plans is sharing information regarding TMHP’s implementation of a new login platform, TMHP IAMOnline, which will serve as the single sign‑on entry point for Texas Medicaid Provider portal applications. What Providers Need to Do: Follow the...