The Department of Aging and Disability Services is re-issuing this letter to provide updated
information about effective dates for the changes discussed in the original letter. The original letter
(Information Letter 2014-68, Nursing Facility Transition: Nursing Facility Changes to the
Medicaid Claims Submission Process) was posted on October 21, 2014. This letter replaces the
previously published letter.
In conjunction with the transition of nursing facilities (NFs) to STAR+PLUS managed care on
March 1, 2015, the following information must be included on NF claims submitted to Texas
Medicaid & Healthcare Partnership (TMHP) as indicated in this letter.
Updates to institutional claim templates and/or batches will be required to accommodate these
changes. Additionally, third-party submitters must be informed of these changes for claims to be
successfully submitted. Providers are responsible for notifying third-party submitters regarding the
changes outlined in this letter.
Taxonomy Required on NF Claims – Effective February 1, 2015
NFs will be required to enter the appropriate Healthcare Provider Taxonomy Code associated to
the National Provider Identifier (NPI) of the billing entity on all Long Term Care (LTC) NF
institutional claims submitted to TMHP using TexMedConnect or Electronic Data Interchange
(EDI). Taxonomy codes further define the type, classification, and/or specialization of the health
care provider. If a provider attempts to submit a claim to TMHP without a valid taxonomy code,
regardless of the date of service, the claim will be rejected and providers will receive an error
According to the Centers for Medicare and Medicaid Services, all health care providers must select
a taxonomy code(s) when applying for an NPI. NF claim submitters should enter the taxonomy
code which best describes the service being billed on the claim. The most common NF taxonomy
• 314000000X = Skilled NFs; and
• 313M00000X = Other NFs.
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