News Blog

Provider Alert!
08Dec

Provider Alert! Inpatient Prepayment Review Program

Date: December 6, 2022 Attention: Hospital Providers and Inpatient Facilities 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 address some of the questions we have been receiving related to prepayment claims reviews.  Texas Children’s Health Plan (TCHP)...

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Provider Alert!
08Dec

Provider Alert! Update: New Collaborative Care Model Medicaid Benefit; Attestation Form Now Available

Date: December 5, 2022 Attention: All Providers Effective Date for attestation form: January 1, 2023 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 providers that the Health and Human Services Commission (HHSC) has drafted a new Medicaid...

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Provider Alert!
06Dec

Provider Alert! EVV Home Health Care Services (HHCS)- Services Updates and Bill Codes Table Now Available

Date: November 30, 2022 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers The updates to the impacted services required to use EVV by January 1, 2024 (PDF) 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 share...

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06Dec

Provider Alert! COVID-19 Disaster Declaration – ALERT #5 – Prior Authorization Adjustments

Date: November 30, 2022   Attention: All ProvidersEffective Date: November 21, 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. The Prior Authorization Adjustments listed here are extended until January 31, 2023. This COVID-19 Disaster Declaration extension does NOT apply to 90-day authorizations. As of January 1, 2021, 90-day...

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Provider Alert!
06Dec

Provider Alert! Telemedicine/Telehealth claims guidance

Date: November 30, 2022 Attention: All Providers Effective Date: November 21, 2022 Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission.The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March 31, 2022 as announced by the Health...

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06Dec

Provider Alert! COVID-19 UPDATE ALERT #4 – Telemedicine Services – Physicians, BH, FQHC and RHC Providers

Date: November 30, 2022 Attention: All providers Effective Date:November 21, 2022 The content in this message on Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission. The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March 31,...

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05Dec

Provider Alert! CHIP co-pays waived for office visits in response to COVID-19

Date: November 30, 2022              Attention: All Providers Effective Date: November 21, 2022 The content in this message will remain in effect through January 31, 2023 as announced by the Health and Human Services Commission.TCHP COVID-19 Utilization Management Procedure and provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ 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...

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Provider Alert!
01Dec

Provider Alert! You’re Invited to Our Provider Advisory Group!  

Date: November 30, 2022 Attention: All Providers Event dates are based on Service Delivery Area: Tuesday, December 13, 2022 Northeast SDA Wednesday, December 14, 2022 Jefferson SDA Thursday, December 15, 2022 Harris SDA All sessions will be from 6:00-7:30PM CST Call to action: Texas Children’s Health Plan (TCHP) invites you to our new Provider Advisory Group. We will hold our inaugural round of sessions next month and dates are based on Service Delivery Area as described above. Click here if you are...

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Provider Alert!
29Nov

Provider Alert! Prior Authorization Criteria Update for Zolgensma Scheduled for February 1

Date: November 28, 2022 Attention: Providers Effective date: February 1, 2023 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) will update the prior authorization criteria for Zolgensma (J3399) effective February 1, 2023. TCHP will remove the Spinal Muscular Atrophy (SMA) type...

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Provider Alert!
29Nov

Provider Alert! Prior Authorization Criteria for Carvykti Begins December 1, 2022

Date: November 28, 2022 Attention: Providers Subject: 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: Texas Children’s Health Plan (TCHP) will revise clinical prior authorization criteria for Carvykti (Ciltacabtagene autoleucel) effective December 1, 2022. It is a B-cell maturation antigen-directed genetically...

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