Provider Alert! Reminder: Authorization Requirements and Code Configuration

Provider Alert! Reminder: Authorization Requirements and Code Configuration

As a reminder, Texas Children’s Health Plan continues to require authorization for the following service categories:

  • Bariatric surgery
  • Circumcision in children 1 year of age and older
  • General anesthesia for dental procedures for children 6 years and under (STAR and STAR Kids only)
  • Oral surgery and medically necessary dental procedures
  • Therapeutic and reconstructive breast procedures (including breast prosthesis)
  • TMJ diagnosis and treatment
  • Transplant services

Providers will be able to access a complete list of codes that require an authorization in these categories on the Texas Children’s Health Plan Provider Portal after August 30, 2018. You can access the Provider Portal at www.TexasChildrensHealthPlan.org/for-providers.

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