FQHC and RHC Home Telemonitoring Providers Required to Use Procedure Code S9110 With Modifier U3
If your practice operates as a federally qualified health center (FQHC) or rural health clinic (RHC) and you have been billing home telemonitoring services, there is a coding change you need to act on immediately.
Effective April 28, 2026, for all dates of service on or after January 01, 2026, home telemonitoring providers at federally qualified health centers and rural health clinics are required to use procedure code S9110 paired with modifier U3 when submitting or resubmitting claims to the Texas Medicaid and Healthcare Partnership. Procedure code G0511, which was previously used for these services, has been discontinued and should no longer appear on any claims going forward.
The Texas Health and Human Services Commission has stepped in to ease the transition by waiving both the 95-day filing deadline and the 120-day appeal deadline for affected claims. Additionally, Texas Medicaid & Healthcare Partnership (TMHP) will automatically identify and reprocess claims with dates of service from January 01, 2026, onward. Providers do not need to file appeals unless a claim is denied for reasons beyond this coding issue after reprocessing wraps up.
One thing worth keeping in mind: Texas Medicaid managed care organizations (MCOs) operate differently from traditional fee-for-service Medicaid. Administrative processes including prior authorization, precertification, referrals, and claims filing can vary significantly from one MCO to another. If you are enrolled with an MCO, contact them directly for guidance specific to your plan.
