Monthly Archives - October 2022
17Oct

Provider Alert! COVID-19 Procedure Code Updates for Second Quarter 2022 HCPCS

Date: October 12, 2022 Attention: All Providers Effective Date: June 23, 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: Texas Children Health Plan (TCHP) would like to inform providers that on June 23, 2022, the Texas Medicaid & Healthcare Partnership (TMHP) implemented the second...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
14Oct

Provider Alert! CPT Codes for Vision Testing Reminder

Date: October 12, 2022 Attention: All Providers 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: The purpose of this communication is to remind providers about Texas Children’s Health Plan’s (TCHP) Current Procedural Terminology (CPT) codes for vision testing and medically necessary eye examinations. Vision...

By Events, Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , , 0 CommentsRead more...
Provider Alert!
13Oct

Provider Alert! September 2022 Specialty Drug List Available

Date: October 11, 2022 Attention: All Providers Effective Date: September 28, 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: The September 2022 Biannual Specialty Drug List (SDL) is now available from the vendor drug program website. How this impacts providers: Providers should refer to the vendor...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
13Oct

Provider Alert! Bivalent Pfizer COVID-19 Booster Vaccine Coverage Update

Date: October 12, 2022 Attention: All Providers Effective Date: August 31, 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: Texas Children’s Health Plan’s (TCHP) would like to notify providers that on August 31, 2022, the U.S. Food and Drug Administration (FDA) amended the...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
12Oct

Provider Alert! COVID-19 Vaccine Administration Procedure Codes 0124A & 0134A Are Now Benefits for Medicaid & CHIP

Date: October 12, 2022 Attention: All Providers Effective Date: August 31, 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: Texas Children Health Plan (TCHP) would like to inform providers that effective for dates of service on or after August 31, 2022, in accordance with...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
12Oct

Provider Alert! Changes to the STAR Kids LTSS Billing Matrix and Crosswalk Effective December 1, 2022

Date: October 12, 2022 Attention: All Providers Effective Date: December 1, 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: UPDATE October 10, 2022: On June 1, 2022, the Health and Human Services Commission (HHSC) comprehensively revised the Long-Term Services and Supports (LTSS) Billing Matrices and...

By Events, Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
12Oct

Provider Alert! PDL Prior Authorization Criteria Revisions Scheduled for October 11

Date: October 11, 2022 Attention: All Providers Effective Date: October 11, 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: Effective October 11, 2022, Texas Children's Health Plan (TCHP) will revise the preferred drug list (PDL) prior authorization criteria guide for the Bronchodilators, Beta Agonists,...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...
Provider Alert!
07Oct

Provider Alert!Criteria Changes for Subsequent Dosing of Palivizumab (Synagis) with Fall/Winter Traditional Respiratory Syncytial Virus Season

Date: October 5, 2022 Attention: All Providers Effective Date: Fall/Winter traditional RSV season   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 Health Plan (TCHP) would like to inform providers that Palivizumab (Synagis) prior approval criteria will change for subsequent dosing with Fall/Winter traditional Respiratory...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
06Oct

Provider Alert! Clinical Prior Authorization Criteria Revisions Implement for Medicaid Fee-for-Service on October 26

Date: October 5, 2022 Attention: All Providers Subject: Effective Date: October 26, 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: Texas Children Health Plan (TCHP) will revise the clinical prior authorization criteria for the Anxiolytics and Sedative/Hypnotics (ASH), Attention Deficit Disorder/Attention-Deficit Hyperactivity Disorder (ADD/ADHD), and Qelbree (also within the...

By Events, Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , , , 0 CommentsRead more...
Provider Alert!
06Oct

Provider Alert! Case Management for Children and Pregnant Women (CPW) Carve-In

Date: October 5, 2022 Attention: All Providers Effective date: September 1, 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: The purpose of this communication is to inform our providers of the Case Management for Children & Pregnant Women (CPW) carve-in to Medicaid that became...

By Events, Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , , , 0 CommentsRead more...