Provider Alert

Articles with information about Provider Alerts.

Provider Alert!
28Jul

Provider Alert! Updates to the Texas Medicaid Provider Procedures Manual

Attention: Radiologists, Cardiologists, Imaging Services, Ophthalmologists, Optometrists Effective Date: August 1, 2020 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) aligns with the Texas Medicaid Healthcare Partnership (TMHP) regarding the benefit criteria in the Medical and Nursing Specialists, Physicians...

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Provider Alert!
28Jul

Provider Alert! Age and diagnosis restrictions for Code J0180

Attention: Geneticists Effective Date: July 28, 2020 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) aligns with the Texas Medicaid Provider Procedures Manual (TMPPM) and there is no authorization requirement for Fabrazyme Injection, agalsidase beta Code J0180. TCHP does apply...

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Provider Alert!
27Jul

Provider Alert! OB/GYN Telemedicine CPT Code 59430

Attention: Obstetric Care Providers Effective Date: April 1, 2020 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) has configured CPT Code 59430 under vaginal delivery, antepartum and postpartum care procedures as an acceptable billing code with no restrictions for...

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Provider Alert!
27Jul

Provider Alert! Second Quarter 2020 HCPCS Updates for Texas Medicaid

Attention: All Providers Effective Date: July 1, 2020 Updated September 10, 2020 Call to action: Texas Children’s Health Plan (TCHP) aligns with the Healthcare Common Procedure Coding System (HCPCS) additions, revisions, and discontinuations that are implemented for claims processing by TMHP for Texas Medicaid. How this impacts providers: Second Quarter 2020 HCPCS Added Procedure Codes are as follows: Clinician Administered Drug (CAD) Procedure Codes C9061 J0223 J0691* J0742 J0791* (replacing C9053) J0896  J7169* J7204 J9177 J9246 J9358 Q5119 Q5120     The follow codes have age restrictions: J1201 – 6 months and older J1558 – 2 years and older J0791 – 16...

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Provider Alert!
24Jul

Provider Alert! Medicaid drug formulary changes

Attention: All Providers Effective Date: July 31, 2020 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 Texas Vendor Drug Program (VDP) will implement changes to the state Medicaid drug formulary, effective Thursday, July 30, 2020. Select medications will be moving from “preferred” to “non-preferred” status and...

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24Jul

Provider Alert! COVID- 19 testing information and resources

Attention: All Providers Effective Date: July 24, 2020 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 following Provider guidance is provided as a TCHP educational communication only. As many of our network providers are affiliated with other institutions and organizations who also set policy and procedure, this communication...

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Provider Alert!
22Jul

Provider Alert! Update to Gait Trainers and Standers Guidelines

Attention: All Providers Effective Date: July 22, 2020 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: This is a reminder that Texas Children’s Health Plan (TCHP) requires authorization of all gait trainers and standers, including all accessories. There is one addition to the guideline, which aligns...

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Provider Alert!
20Jul

Provider Alert! Healthy Texas Women Program Benefits

Attention: Primary Care and Obstetric Care Providers Effective Date: July 20, 2020 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 remind providers of the Healthy Texas Women (HTW) Program and the benefits available to their patients. The Healthy...

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Provider Alert!
16Jul

Provider Alert! Guidance for first-line treatment of pediculosis capitis (head lice)

Attention: Primary Care Providers Effective Date: July 16, 2020 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: Head lice infestations affect millions of children and their families every year.  These incidents result in direct and indirect social and economic burdens as infestations spread among household members...

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Provider Alert!
13Jul

Provider Alert! Behavioral Health Screening Reminders

Attention: Primary Care Providers and Obstetric Care 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: Texas Children’s Health Plan would like to remind Primary Care Providers and Obstetric Care Providers of the importance of screening for depression during the office visit. Mental health...

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