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Benefit Amount, Duration and Scope

Cook Children's Health Plan follows the benefit amount, duration and scope as set forth in the Texas Medicaid Provider Procedures Manual. As such, it’s the Provider's responsibility to verify that the code is a benefit of Texas Medicaid by utilizing the Texas Medicaid Provider Procedures Manual and the Medicaid Fee Schedule.

For services outside the benefit amount, duration and scope or out of network services would require prior authorization.

Helpful information and resources for our Providers.

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In the event of an outage contact Provider Relations at 1-888-243-3312 or CCHPProviderRelations@cookchildrens.org.