TX · guidance
Tex. HHSC Medicaid Hospice Provider Manual § 4200
Claims Management Systems (CMS)
Revision 06-2; Effective December 12, 2006
CMS was established to be the reimbursement method for all Long Term Care Programs effective Sept. 1, 1999. Hospice providers use CMS to submit claims to HHSC, which are submitted through TDH Connect. For more information on how to bill electronically, call 800-626-4117.
Form 1290, Long Term Care Claim, is a paper voucher used for reimbursement if the electronic software supplied by TMHP is not obtained.
Form 1290 must be completed for each client and mailed to:
Texas Medicaid & Healthcare Partnership
Attention: Long Term Care MC-B02
P.O. Box 200105
Austin, TX 78720-0105
If you need assistance filling out the paper claim form or want to obtain the electronic CMS software, call 800-626-4117. A TMHP representative will assist you.
Do not mail Form 1290 to HHSC.
Provenance
- Source
- fhb.hhs.texas.gov
- Retrieved
- 2026-10-01
- Edition
- mhpm-2011-05-11
- Content hash
8d1330722725d9b3b31f10dcf668dee88d0d06179b1507172f42a274e5553a62
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