Provider Alert! COVID-19 At-home Test Kits Available as a Pharmacy BenefitTexas Children's Health Plan
Date: January 4, 2022
Attention: All Providers
Effective date: January 3, 2022
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: HHSC will allow COVID-19 at-home test kits as a Medicaid and Children’s Health Insurance Program (CHIP) pharmacy benefit beginning January 3, 2022. Members may obtain COVID-19 at-home test kits from a Medicaid-enrolled retail pharmacy with or without a prescription from a prescribing provider. Texas Childrens Health Plan will allow for a maximum quantity of 4 tests per calendar month. Prescriptions can be processed using single packs (1 test) or multi-pack test kits (2 tests), equaling a total of 4 at-home COVID-19 tests per month. As an example:
- 1 single-pack kit (1 test) – allows 4 kits per calendar month
- 1 multi-pack kit (2 tests) – allows 2 kits per calendar month
How this impacts providers: When prescribing a COVID-19 test kit, the prescribed quantity and any applicable refills may not exceed the benefit limit of 4 tests per calendar month.
List of Allowable Test Kits
|COVID-19 Test-Kit Name||NDC||Package Size|
|InteliSwab COVID-19 Rapid Test||08337-0001-58||2 tests|
|QuickVue At-Home OTC COVID-19 Test||14613-0339-37||1 test|
|QuickVue At-Home OTC COVID-19 Test||14613-0339-72||2 tests|
|BinaxNOW COVID-19 AG Card||11877-0011-29
|BinaxNOW COVID-19 AG Card Home Test||11877-0011-33
|BinaxNOW COVID-19 AG Self Test||11877-0011-40||2 tests|
|Everlywell COVID-19 Test Home Collection Kit DTC||51044-0008-42||1 test|
Next steps for providers: Prescribers should communicate these changes to their staff.
If you have any questions, please email Provider Network Management at: TCHPPharmacy@texaschildrens.org.