Provider Alert! Cystic Fibrosis and Spinal Muscular Atrophy Screening Authorization No Longer Required
Date: May 27, 2021
Attention: Obstetric Care Providers
Effective Date: June 1, 2021
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 network providers that beginning June 1, 2021; a prior authorization is no longer required for the following genetic screenings:
- Spinal Muscular Atrophy screening, SMA 81329
- Cystic Fibrosis screening, CF 81220
- Prenatal carrier screening for pregnant women recommended by the American College of Obstetricians and Gynecologists for Spinal Muscular Atrophy and Cystic Fibrosis
- Texas State Newborn screening includes Cystic Fibrosis
Spinal Muscular Atrophy will be added 6/1/21
How this impacts providers: Benefit is a once per lifetime max. As a reminder, TCHP utilizes Quest Diagnostics as our exclusive reference lab provider. Providers must refer members for this screening to Quest Diagnostics.
Next steps for providers: Providers should share this communication with their staff.
If you have any questions, please email Provider Network Management at: firstname.lastname@example.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers