Provider Alert! Sleep Study Prior Authorization Update
Date: August 19, 2021
Attention: Primary Care Providers , Neurologists
Effective Date: December 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: Effective December 1, 2021, Texas Children’s Health Plan will require a prior authorization for sleep studies for Members ages over 18 years old. This applies to the following CPT Codes: 95805, 95810, and 95811.
How this impacts providers: When applicable, providers should utilize this Standard Prior Authorization Form and request an authorization.
Medical Services Fax Line – 832-825-8760 or Toll-Free 1-844-473-6860
Next steps for providers: Providers should share this prior authorization update with their staff.
If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.
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