Texas Outpatient Claim Medicaid Pricer

Price a whole Texas Medicaid hospital outpatient claim at once. Enter the billing hospital, the date of service, and the claim lines as they appear on the UB-04, and the tool applies Texas's claims-level payment rules on top of the per-code rates to return an allowed amount for every line and a total for the claim. See About This Data for more information on our sources and methodology.

New here? Use this to load a sample, then click Estimate Rate. Your result will appear below.

Claim

Provider(populate at least one)

Provider Name

NPI

CCNi

Date of Servicei

Emergency Claimi

Child Patienti

Claim Lines

Lines span multiple daysi

#	Rev Code *	HCPCS	Mod	Units	Charges
1
2
3

3 of 99 lines

Your result will appear here

Enter the claim above and hit Estimate Rate to see every line's allowed amount, the rules that applied, and the claim total. Or use Try Demo at the top to load a sample.