Provider Alert! Benefit Changes Prior Authorization Update

Provider Alert!

Provider Alert! Benefit Changes Prior Authorization Update

Attention: All Texas Children’s Health Plan Providers
Subject: UPDATE to Changes for Physical, Occupational, and Speech Therapy Benefits


Prior Authorization Changes Update
Changes to TCHP Prior Authorizations for PT, OT, and ST services:

  • For therapy authorizations with approved dates of service spanning the 9/1 transition date,
    TCHP created a revised authorization in our system that reflects the new billing structure
    using the same authorization number.
  • For all therapy requests that were submitted prior to 9/1, the revised authorization will start
    on 9/1 and cover through the end of the authorized period. Providers will not need to
    change their authorization reference number for claims submission.
  • Providers should bill according to correct billing structure for the date of service.
    There is no further action required from providers.
  • TCHP will continue to prefer the Texas Standard Prior Authorization form available on our
    website for Therapy requests.


Please utilize the Utilization Management Authorization fax line for the following services:

  • Medical Services
    832-825-8760 or Toll Free 844-473-6860
  • Behavioral Health Services
    832-825-8767 or Toll Free 844-291-7505

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