Monthly Archives - June 2020

Provider Alert!
17Jun

Provider Alert! Additional Diagnosis Codes and Place of Service Added for Ravulizumab-cwvz (Ultomiris)

Attention: Hematologists, Gastroenterologists, Rheumatologists Effective Date: June, 1 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Texas Children’s Health Plan (TCHP) would like to inform you that we align with Texas Medicaid Provider Procedure Manual (TMPPM) regarding the guidelines for ravulizumab-cwvz, (Ultomiris), procedure code J1303....

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Provider Alert!
16Jun

Provider Alert! Reminder: Appointment availability standards for Obstetric providers

Attention: Obstetric Care Providers Effective Date: June 16, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Texas Children’s Health plan (TCHP) would like to remind our Obstetric Care providers of the appointment availability standards recognizing the importance of the adherence to the standards. Network...

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Provider Alert!
15Jun

Provider Alert! New Federal Enhanced Provider Relief Funds for Medicaid and CHIP Providers

Attention: All Providers Effective Date: June 10, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Texas Children’s Health Plan (TCHP) would like to inform you of new federal Enhanced Provider Relief Funds for Medicaid and CHIP providers. Here are the details: Beginning June 10, eligible...

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Provider Alert!
12Jun

Provider Alert! Positive Pressure Airway (PAP) device guideline

Attention: All Providers Effective Date: June 17, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: TCHP would like to inform you of recent updates to the guidelines for home health, speech therapy, and positive pressure airway (PAP) devices. Updates include the following: Home health guideline:...

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12Jun

Consumer Directed Services Employers Survey

For Providers: Consumer Directed Services Employers Survey Dear Consumer Directed Services employers, This notice is to inform you of a survey the Health and Human Services Commission (HHSC) Rate Analysis Department will release beginning Monday, June 15, 2020 and last through Wednesday, July 15, 2020. Click here to Learn More Click here to see more important Notices for Providers.

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Provider Alert!
12Jun

Provider Alert! Updates to Behavioral Health Inpatient and Outpatient Testing Evaluations

Attention: Behavioral Health Providers and Inpatient Facilities Effective Date: January 1, 2019 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Effective January 1, 2019, the benefit criteria for psychological, neurobehavioral, and neuropsychological testing for inpatient behavioral health and outpatient mental health services has changed for...

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Provider Alert!
12Jun

Provider Alert! Updated reimbursement information for Inpatient Genetic Services

Attention: Geneticist Effective Date: May 1, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: TCHP would like to inform you of a recent update to the reimbursement information for inpatient genetic service codes 99254 and 99255. Effective for dates of service on or after...

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Provider Alert!
10Jun

Provider Alert! Update: Updates to Prior Authorization Requirements

Attention: All Providers Effective Date: June 4, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.  Call to action: TCHP would like to inform you of recent updates to the prior authorization requirements and the effective dates. Updates include the following:  Medical services now requiring prior authorizations:  Therapeutic Continuous Glucose Monitors-...

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Provider Alert!
10Jun

Provider Alert! COVID-19/Hydroxychloroquine Prescribing Revised Update from April 2, 2020

Attention: All Providers and Pharmacies Effective Date: June 9, 2020 Call to action: The Texas State Board of Pharmacy has modified the emergency basis rule when dispensing prescriptions for chloroquine, hydroxychloroquine, mefloquine, and azithromycin.  Physicians no longer have to include the diagnosis on the prescription. Additionally, the rule does not prevent a physician from prescribing one of these drugs for an off-label use.    How this impacts providers and pharmacies:  A diagnosis is no longer required to be provided on prescriptions for the above medications. Prescriptions may be written for off-label use.    Next...

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Provider Alert!
10Jun

Provider Alert! Continuing Medical Education/Ethics: Neonatal Abstinence Syndrome Awareness Month resources and events online

Attention: All Obstetric Care Providers Effective Date: June 4, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: In recognition of Neonatal Abstinence Syndrome (NAS) Awareness Month for the month of June, Texas Children’s Health plan (TCHP) would like to inform you of resources and...

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