Provider Alert! Prior Authorization Changes ComingTexas Children's Health Plan
Attention: All TCHP Providers
Subject: TCHP Prior Authorizations
TCHP will be updating the services requiring a prior authorization effective April 1, 2017.
Please note there are some key changes to make providers aware of.
- Physical Therapy, Occupational Therapy and Speech Therapy re-evaluations will no longer need
to be prior authorized. The CPT codes for these services are: 97164, 97168, S9152
- Spinraza(Nusinersen) has been added as a Medical Benefit by TMHP. Spinraza(Nusinersen) will
require a prior authorization. TCHP will follow TMHP coding guidance located at
A new TCHP prior authorization list will soon be posted at http://www.tchp.us/forproviders/
Please contact TCHP Provider Relations at 800-731-8527 for any questions.