Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 355 - REIMBURSEMENT RATES
Subchapter J - PURCHASED HEALTH SERVICES
Division 3 - PHYSICIAN SERVICES
Section 355.8041 - Recipient-Initiated Second Opinions

(a) The Texas Medicaid Program may now reimburse physicians when a Medicaid recipient requests a second opinion regarding surgery. Payment will be made for the second opinion according to the physician's profile allowance for initial office visit procedures and difficulty of the examination.

(b) Recipients are encouraged to have their medical records made available to the second physician to avoid duplication of diagnostic testing. However, payment may be made for covered diagnostic services deemed necessary by the second physician.