Specialists

Articles with relevant information for Specialists.

Provider Alert!
10Mar

Provider Alert! Cytokine and CAM Antagonists Criteria Updates Scheduled for April 5

Date: March 10, 2022 Attention: Providers Effective Date: April 5th, 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: On April 5, 2022, HHSC will make the following revisions to various Cytokine and CAM Antagonists clinical prior authorization criteria to ensure alignment with US Food and Drug...

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Provider Alert!
10Mar

Provider Alert! Changes for Client Access to Mosquito Repellent Benefit Begin June 1

Date: March 10, 2022 Attention: Providers Effective Date: June 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: Beginning May 31, 2022, HHSC will stop using the Texas Medicaid Standing Order for Mosquito Repellent How this impacts providers: Pharmacies must obtain a prescription from a Medicaid-enrolled prescribing...

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Provider Alert!
03Mar

Provider Alert! Abbott Recall of Certain Powdered Formulas: Similac, Alimentum, EleCare, Elecare Jr. and Similac PM 60/40

Date: March 2, 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. Regarding system configuration updates, TCHP will apply updates and reprocess impacted claims as soon as possible. However, due to volume, please allow up to sixty (60) business days to complete. Providers...

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03Mar

Provider Alert! COVID-19 Drug Veklury (Remdesivir) is a covered benefit for Medicaid and CHIP clients

Date: March 3, 2022 Attention: Providers Effective Date: January 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. Call to action: Beginning January 21, 2022, Veklury (J0248) is a covered benefit for Medicaid and CHIP clients when used in an outpatient setting. How this impacts providers: On January 21,...

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Provider Alert!
22Feb

Provider Alert! EVV Policy Handbook Revisions

Date: February 21, 2022 Attention: Financial Management Services Agencies and Consumer Directed Services employers Effective date: March 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: TCHP would like to inform providers of upcoming revisions to the Electronic Visit Verification (EVV) Policy Handbook that...

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21Feb

Provider Alert! CME event is coming up. Register Today!

Achieving Asthma Success Ensure that patients have the best possible asthma care, can reduce asthma triggers and recognize their medication. Date:  Thursday, March 3, 2022 Time:  5:30-7:30 p.m. Location:  Virtual Event (held via WebEx) Learning Objectives: Identify signs and symptoms that are indicative of asthma Demonstrate how to teach patients about self-monitoring and triggers Discuss the criteria that indicate the best results for asthma control Implement strategies for use of TCHP asthma high risk report in patient care To register, click here. For questions, please email tchpcme@texaschildrens.org. Presented by: Lisa Fuller, MD – Medical...

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Provider Alert!
16Feb

Provider Alert! Efficient Payment Option with Electronic Funds Transfer

Date: February 8, 2022 Attention: All Providers Subject: Efficient Payment Option with Electronic Funds Transfer 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 Texas Children’s Health Plan (TCHP) providers of the electronic payment option available to expedite payment...

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Provider Alert!
16Feb

Provider Alert! Gene Expression Profiling Procedure Code 81520 to Become a Benefit Effective April 1, 2022

Date: February 9, 2022 Attention: Providers Subject: Effective Date: April 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: On September 11, 2020, Texas HHSC received a medical benefit request to add Prosigna®, a type of gene expression profiling, as a benefit of Texas Medicaid. Prosigna®...

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Provider Alert!
11Feb

Provider Alert! 2022 Healthcare Common Procedure Coding System (HCPCS) Update

Date: February 11, 2022 Attention: All Providers Effective Date: January 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) aligns with the Healthcare Common Procedure Coding System (HCPCS) additions, revisions, and discontinuations that are implemented for claims processing by TMHP...

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10Feb

Provider Alert! COVID-19 Vaccine Administration Procedure Code 0073A is now a Benefit

Date: February 9 , 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: Effective for dates of service on or after January 3, 2022, COVID-19 vaccine administration code 0073A is a benefit of Medicaid and CHIP...

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