Specialists

Articles with relevant information for Specialists.

Provider Alert!
15Jun

Provider Alert! Prior Authorization Criteria Update for Aduhelm Begins July 1

Date: June 15, 2022 Attention: All Providers Subject: Prior Authorization Criteria Update for Aduhelm Begins July 1 Effective Date: July 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) would like to inform providers that the Health and Human Services Commission...

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Provider Alert!
13Jun

Provider Alert! Clarification for the STAR Kids LTSS Billing Matrix Revisions

Date: June 6, 2022                         Attention: STAR Kids Providers Effective date: December 1, 2022 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are...

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Provider Alert!
13Jun

Provider Alert! Vesta Windows Ends Aug. 31, 2022

Date: June 10, 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 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 notify program providers, Financial Management Services Agencies, and Consumer Directed Services employers using DataLogic Vesta Windows that they...

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13Jun

Provider Alert! TMPPM Update for Monoclonal Antibodies Benralizumab, Mepolizumab, and Reslizumab

Date: May 24, 2022 Attention: All Providers Effective Date: April 1, 2022 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: Beginning April 1, 2022, Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual, Outpatient Drug Services Handbook section 7.57.5, “Prior Authorization for Omalizumab,...

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Provider Alert!
07Jun

Provider Alert! Pfizer COVID-19 Vaccine Booster Dose for Children Update

Date: June 7, 2022 Attention: All Providers Effective Date: May 17, 2022 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 inform providers that on May 17, 2022, the U.S. Food and Drug Administration (FDA) amended the emergency use...

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Provider Alert!
06Jun

Provider Alert! Clarification for the STAR Kids LTSS Billing Matrix Revisions

Date: June 6, 2022                        Attention: STAR Kids Providers Effective date: December 1, 2022 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are...

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03Jun

Provider Alert! Spikevax COVID-19 Vaccine Coverage Update

Date: June 3, 2022 Attention: All Providers Effective Date: June 1, 2022 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: TCHP (Texas Children’s Health Plan) would like to inform providers that on January 31, 2022, the U.S. Food and Drug Administration (FDA) issued full approval of...

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Provider Alert!
02Jun

Provider Alert! June 2022 TMPPM Procedure Code Updates

Date: June 1, 2022 Attention: All Providers Effective Date: June 1, 2022 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 inform providers that the Health and Human Services Commission (HHSC) staff continues to revise the Texas Medicaid...

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Provider Alert!
02Jun

Provider Alert! Prior Authorization Criteria Updates for Yescarta and Tecartus

Date: June 1, 2022 Attention: All Providers Effective Date: July 1, 2022 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 inform providers that the Health and Human Services Commission (HHSC) will update prior authorization criteria for Yescarta (Q2041)...

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02Jun

Provider Alert! Booster Dose Moderna COVID-19 Vaccine for Adults Added to the Formulary

Date: May 31, 2022 Attention: All Providers Effective Date: May 13, 2022 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 inform providers that the U.S. Food and Drug Administration (FDA), under an emergency use authorization (EUA), authorized the...

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