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.

Source Note: The provisions of this §355.8041 adopted to be effective March 26, 1979, 4 TexReg 787; transferred effective September 1, 1993, as published in the Texas Register September 7, 1993, 18 TexReg 5978; duplicated effective September 1, 1997, as published in the Texas Register December 11, 1998, 23 TexReg 12660