The Affordable Care Act provides a rate increase for certain primary care Medicaid services in 2013 and 2014. Texas is issuing quarterly supplemental payments to providers to cover the difference between the regular Medicaid rate for the service and the temporary increase.
To get the rate increase payments, physicians must meet one of these standards:
Be board certified in family medicine, general internal medicine, pediatric medicine or a subspecialists within those designations as recognized by the American Board of Medical Specialties, the American Osteopathic Association, or the American Board of Physician Specialties.
Or
Have 60 percent of their Medicaid billings for the prior year from the Evaluation and Management (E&M) codes specified in federal regulation. Services eligible for the rate increase are E&M codes 99201 through 99499, and services related to the Administration of Vaccines (90465, 90466, 90467, 90468, 90471, 90472, 90473 and 90474).