Background:

Procedure codes C9803 for specimen collection and S8301 for personal protective equipment above and beyond normal protocol are a benefit of Texas Medicaid, effective March 1, 2020 and April 1, 2020 respectively. 

Community First Health Plans (CFHP) will waive the 95-day filing deadline under Title 1, Part 15, Chapter 354, Medicaid Health Services, Subchapter A, Division 1, §354.1003: 

D) Submission of claims occurred within the 365-day federal filing deadline, but the claim was not filed within 95-days from the date of service because the service was determined to be a benefit of the Medicaid program and an effective date for the new benefit was applied retroactively.

Action:

Claims that denied or that did not include the additional payment for the above referenced codes, within the dates of service on or after March 1, 2020 (C9803) and April 1, 2020 (S8301) respectively, will be automatically reprocessed no later than 60 days after HHSC retroactively adjusts the Medicaid fee schedule.  No interest is due to providers for claims that fall into either of these scenarios.

No further action is required on your part unless you still need to file claims for these services.  Should you need additional information, please contact the Network Management Department at 210-358-6294.