COVID-19 Testing in Pharmacy Reimbursable Through Medicaid Medical Claims System

Published on
April 30, 2021

On April 13, 2021, HHSC updated the fee-for-service medical claims system to allow for reimbursement to pharmacists and pharmacy providers for COVID-19 tests provided in the pharmacy setting. Pharmacies and pharmacists interested in administering COVID-19 tests to people enrolled in Medicaid must complete an enrollment application at tmhp.com/topics/provider-enrollment. For people enrolled in Medicaid managed care, pharmacies and pharmacists must enroll with the MCO in their service area. Contact the TMHP Contact Center at 1-800-925-9126 or e-mail TMHP Provider Relations to request assistance from the local TMHP provider relations representative in your area.