Specialists

Articles with relevant information for Specialists.
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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04Feb

Provider Alert! Monoclonal Antibody Therapy Procedure Codes for COVID-19 Treatment Added to Texas Medicaid Benefits

Date: February 2, 2022 Attention: All Providers Effective Date: December 8, 2021 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 December 8, 2021, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the AstraZeneca product Evusheld (tixagevimab co-packaged with cilgavimab),...

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03Feb

Provider Alert! COVID-19 Vaccine Booster Update

Date: January 31, 2022 Attention: All Providers Effective Date: January 3, 2022 for Pfizer COVID-19 Vaccine Booster Dose Age Change 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 January 3, 2022, the U.S. Food and Drug Administration (FDA) amended the emergency use authorization (EUA)...

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Provider Alert!
02Feb

Provider Alert! Inclement Weather Update

Date: February 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. Call to action: Texas Children’s Health Plan (TCHP) is closely monitoring the inclement weather that is forecasted to impact our Service Delivery Areas of Harris, Jefferson, and Northeast, later this week. As always,...

By Events, Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , , 0 CommentsRead more...
Provider Alert!
28Jan

Provider Alert! New Autism Services Benefit for Medicaid Recipients

Date: January 28, 2022 Attention: Primary Care Providers, Developmental Pediatricians, and Neurologists Effective Date: February 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: Effective for dates of service on or after February 1, 2022, Autism Services, to include Applied Behavior Analysis (ABA) evaluation...

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Provider Alert!
28Jan

Provider Alert! Removal of Specialist Requirement from Clinical Prior Authorization Criteria

Date: January 28, 2022 Attention: 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 January 3, 2022, HHSC removed the specialist requirement from the following clinical prior authorization criteria: CGRP Antagonist, Acute CGRP Antagonists, Chronic Emflaza Ophthalmic Immunomodulators Palforzia Transthyretin Agents VMAT2 Inhibitors Wakix Xyrem/Xywav Zelboraf How this impacts providers: Providers...

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Provider Alert!
28Jan

Provider Alert! Prior Authorization Criteria for Enzyme Replacement Therapy

Date: January 28, 2022 Attention: Providers 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: Effective March 1, 2022, HHSC will require prior authorization for all enzyme replacement therapies for Medicaid and CHIP. Enzyme replacement therapy (ERT) is a medical treatment...

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Provider Alert!
25Jan

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: January 25, 2022 Attention: All Providers Subject: Medicaid Preferred Drug List and Formulary Changes Effective Date: January 27, 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 Texas Vendor Drug Program (VDP) implemented changes to the state Medicaid drug formulary, effective Thursday, January 27, 2022....

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Provider Alert!
25Jan

Provider Alert! HHSC Interoperability and Health Information Exchange Survey for Behavioral Health Providers Open

Date: January 25, 2022 Attention: Behavioral Health Providers Survey will be available: January 24, 2022 thru February 18, 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 intent of this survey is to gather information on the interoperability needs and technology readiness of behavioral health...

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Provider Alert!
25Jan

Provider Alert! Signature Requirement Reinstated on DME Forms

Date: January 19, 2022 Attention: DME Providers Effective Date: January 1, 2022 TCHP COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ TCHP network providers should monitor the 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 January 1, 2022, a member or member’s authorized representative’s signature is required on DME Certification and...

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