UPDATED: Office Visit Co-payments Waived for CHIP Members
Date: 03/15/23
Effective with the end of the federal PHE on May 11, 2023, HHSC will end the temporary flexibility that waived office visit co-payments for all CHIP members. For services provided from March 13, 2020 through May 11th, 2023.* Providers must not collect office visit co-payments for CHIP members during this time. Superior HealthPlan will reimburse the provider the full rate for the service, including what would have been paid by the member through cost-sharing.
Effective May 12, 2023, office visit co-payments for all CHIP members can resume.
Providers must attest that the office visit co-payment was not collected by using the following attestation form and submitting an invoice to Superior:
Superior will have 30 calendar days to pay an invoice received from a provider. If Superior has already reimbursed a provider for waived CHIP office visit co-payments without using the attestation form, Superior will document the amount paid and the process used to confirm that a co-payment was not collected by the provider.
For providers providing mental health/substance use disorder (MH/SUD) services, please reference the article: Effective 7/1: CHIP Co-payments Waived for Mental Health and Substance Use Disorder Services
*Please note: Previously, the end date for this guidance was April 30, 2020, then extended to May 31, June 30, July 31, October 23, November 30, December 31, 2020, January 31, February 28, March 31, April 30, May 31, June 30, July 31, August 31, September 30 and October 31; January 31, April 30, May 31, June 30, August 31, September 30, October 31, November 30, January 31 and April 30, 2023. This notice is extended until May 11, 2023.