TX MMP Reimbursement Policies
We want to assist physicians, facilities and other providers in accurate claims submissions and to outline
the basis for reimbursement if the service is covered by a member’s Amerigroup STAR+PLUS MMP
benefits. Keep in mind that determination of coverage under a member’s benefit plan does not
necessarily ensure reimbursement. These policies may be superseded by state, federal or CMS
requirements. Providers and facilities are required to use industry standard codes for claim submissions.
Services should be billed with CPT codes, HCPCS codes and/or revenue codes. The billed code(s) should
be fully supported in the medical record and/or office notes. Industry practices are constantly changing
and Amerigroup STAR+PLUS MMP reserves the right to review and revise its policies periodically.
Policy Disclaimer >>
Policy Definitions >>