Specialists

Articles with relevant information for Specialists.

Provider Alert!
08Sep

Provider Alert! EVV Compliance for State-Required Personal Care Services Providers

Date: September 7, 2021 Attention: Personal Care Services Providers Effective Date: December 1, 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: Effective December 1, 2021, HHSC and TCHP, will begin Electronic Visit Verification Usage reviews to ensure State-required Personal Care Services providers are in compliance...

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08Sep

Provider Alert! Telehealth Services – PT/OT/ST Providers and COVID-19

Date: September 2, 2021 Attention: All providers. Effective Date: September 7, 2021 Providers should monitor the Texas Children’s Health Plan 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) supports the delivery of telehealth (non-physician-delivered) distant site services to its members, and we have implemented special waiver provisions for its use...

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Provider Alert!
30Aug

Provider Alert! Hurricane Ida Information for Medicaid Providers

Date: August 30, 2021 Attention: All Providers Effective Date: August 28, 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: Texas providers rendering services to evacuees from Louisiana due to Hurricane Ida may complete the Hurricane Emergency Expedited Application with Louisiana Medicaid to receive reimbursement for...

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Provider Alert!
27Aug

Provider Alert! Subcutaneous Internal Cardiac Defibrillator (S-ICD) to Become a Benefit for Texas Medicaid

Date: August 25, 2021 Attention: Cardiologists Effective Date: September 1, 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: Effective September 1, 2021, subcutaneous internal cardiac defibrillator (S-ICD) procedure codes 33270, 33271, 33273, 33274, 93287, and 93290 will become a benefit for Texas Medicaid. How this impacts...

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Provider Alert!
27Aug

Provider Alert! Diabetic Equipment and Supplies Benefits to Change for Texas Medicaid

Date: December 17, 2021 Attention: Endocrinologists and Primary Care Providers Effective Date: September 1, 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: New information updated December 17, 2021 with an effective date of September 1, 2021, Diabetic equipment and supplies procedure code A9276 sensor...

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Provider Alert!
27Aug

Provider Alert! Updates for Prostate Surgeries Procedure Codes

Date: August 24, 2021 Attention: Urologists Effective Date: October 1, 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: Effective for dates of service on or after October 1, 2021, reimbursement rate updates for Prostate Surgeries procedure codes will be implemented. How this impacts providers: The following...

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Provider Alert!
27Aug

Provider Alert! Vision Services-Nonsurgical Benefits to Change

Date: August 25, 2021 Attention: Optometrists and Ophthalmologists Effective Date: September 1, 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: Effective September 1, 2021, Texas Children’s Health Plan(TCHP) will implement the Vision Services benefit changes outlined in the TMHP Bulletin Vision Services-Nonsurgical Benefits to Change...

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Provider Alert!
27Aug

Provider Alert! Sleep Study Prior Authorization Update

Date: August 19, 2021 Attention: Primary Care Providers , Neurologists Effective Date: December 1, 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: Effective December 1, 2021, Texas Children’s Health Plan will require a prior authorization for sleep studies for Members ages over 18 years old....

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11Aug

Provider Alert! Modifier CS: cost sharing for COVID-19 testing and visits

Date: August 11, 2021 Attention: All Providers Effective Date: July 27, 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: Modifier CS is not allowable when submitting a Medicaid or CHIP claim related to COVID-19 testing and visits related to testing. How this impacts providers: Providers...

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Provider Alert!
03Aug

Provider Alert! New Procedure Codes Available for Evoked Response Tests and Neuromuscular 

Date: July 28, 2021 Attention: Audiologists, Radiologists, DME, and Lab Providers Effective Date: July 1, 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: Beginning July 1, 2021, Healthcare Common Procedure Coding System (HCPCS) procedure codes 92652 and 92653 (for evoked response tests and neuromuscular), will...

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