Form 5204 Office-Based Procedures Performed in an Ambulatory Surgical Center Pre-authorization Request - Texas

What Is Form 5204?

This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

• Released on February 1, 2020;
• The latest edition provided by the Texas Health and Human Services;
• Easy to use and ready to print;
• Quick to customize;
• Compatible with most PDF-viewing applications;
• Fill out the form in our online filing application.

Download a fillable version of Form 5204 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.