Tag - COVID
08Jan

Provider Alert! Addition of Paxlovid (Pfizer Oral Covid-19 Drug) to Formulary

Date: January 8, 2024 Attention: Providers Effective date: January 4, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective January 4, 2024, the Texas Health and Human Services (HHS) added Paxlovid to the formulary. Paxlovid (nirmatrelvir co-packaged with ritonavir) is an oral antiviral tablet, is indicated for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. How this impacts providers: Please see below for the list...

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05Dec

Provider Alert! Coverage of Commercialized COVID-19 Vaccines Begins as a Pharmacy Benefit

Effective Dates: As of September 11, 2023 & October 3, 2023 Date: December 4, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after September 11, 2023 and October 3, 2023, the U.S. Food and Drug Administration’s (FDA) issued approval and Emergency Use Authorization (EUA) for the following COVID-19 vaccines: As of September 11, 2023: 2023-2024 Pfizer-BioNTech COVID-19 Vaccine 2023-2024 Moderna COVID-19 Vaccine As of October 3, 2023: 2023-2024 Novavax COVID-19 Vaccine The...

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27Nov

Provider Alert! COVID-19 Vaccine Procedure Code 91304

Date: November 27, 2023 Attention: All Providers Effective for dates of service on or after October 3, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after October 3, 2023, in accordance with the U.S. Food and Drug Administration’s (FDA) amended emergency use authorization for the Novavax COVID-19 vaccine, vaccine procedure code 91304 is now a benefit of Medicaid and CHIP. How this impacts providers: COVID-19 vaccine procedure code 91304 is...

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03Nov

Provider Alert! 2023 COVID-19 Vaccine Currently Not Covered on Texas Medicaid and CHIP Formulary

Date: November 3, 2023 Attention: All Providers Call to action:  As of November 1, 2023, COVID vaccines are currently unavailable on the Medicaid and CHIP Formulary at this time. Texas Health and Human Services Commission (HHSC) is working on ways to add the COVID-19 vaccines to the pharmacy benefit. Texas Children’s Health Plan (TCHP) will provide more information as it becomes available.  Next steps for providers:   In the meantime, should your patient inquire about the COVID-19 vaccine, please encourage your patients to receive their...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, Uncategorized, , , , , 0 CommentsRead more...
25Sep

Provider Alert! HHSC Does Not Cover Vaccines or Drugs That Do Not Have FDA Approval or Emergency Use Authorization

Date: September 25, 2023 Attention: All Providers Effective date: August 31, 2023 Call to action: The purpose of this communication is to inform providers that Texas Medicaid and CHIP do not cover vaccines or drugs that are not authorized or approved by the U.S. Food and Drug Administration (FDA). Health and Human Services Commission (HHSC) will not cover procedure codes related to COVID-19 vaccine or drugs administration as non-risk payments (NRP) if the COVID-19 vaccines or drugs no longer have FDA approval or authorization....

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07Aug

Provider Alert! UPDATED: COVID-19 Vaccine Counseling Procedure Code G0315 Now a Benefit

Date: August 7, 2023 Attention: All Providers Effective date: Dates of service on or after December 2, 2021 Call to action: Texas Children Health Plan (TCHP) would like to inform providers that effective for dates of service on or after December 2, 2021, COVID-19 vaccine counseling procedure code G0315 is a benefit of Medicaid for individuals birth through 20 years of age. How this impacts providers: Procedure code G0315 will be limited to a maximum of three vaccine counseling services (G0315), per rolling year...

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13Jul

Provider Alert! Reimbursement for COVID-19 Vaccines for FQHCs and RHCs Reminder

Date: July 13, 2023 Attention: FQHC and RHC Providers End date for vaccine procedure codes: May 12, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to remind FQHC and RHC providers of the guidance from Texas Medicaid and Healthcare Partnership (TMHP) on COVID-19 vaccine procedure codes. Effective for dates of service on or after May 12, 2023, claims submitted by federally qualified health centers (FQHCs) and rural health clinics (RHCs) for the administration of COVID-19 vaccines will no longer be...

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16May

Provider Alert! COVID-19 Vaccine Administration Procedure Code 0174A Is Now a Benefit of Medicaid and CHIP

Date: May 16, 2023 Attention: All Providers Effective date: Dates of service on or after March 14, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after March 14, 2023, in accordance with the U.S. Food and Drug Administration’s amended Emergency Use Authorizations, COVID-19 vaccine administration procedure code 0174A for the administration of the Pfizer-BioNTech COVID-19 vaccine booster is now a benefit of Texas Medicaid and CHIP for individuals 6...

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16May

Provider Alert! Infection Control Supplies Procedure Code S8301 No Longer a Benefit

Date: May 16, 2023 Attention: All Providers Effective Date: May 12, 2023 Call to action: Texas Children Health Plan (TCHP) would like to inform providers that effective with the end of the federal public health emergency (PHE) on May 11, 2023, the Health and Human Services Commission (HHSC) will end multiple temporary flexibilities related to the COVID-19 pandemic. Providers should be aware that this change impacts coverage and reimbursement for procedure code S8301for infection control supplies. Effective for dates of service on or after May...

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15May

Provider Alert! End of COVID flexibilities: Provider Signatures for All Therapy Services and Hearing Screening for Speech Therapy

Date: May 15, 2023 Attention: All Providers Effective date: June 13, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to make providers aware of the end to some COVID flexibilities related to Utilization Management.  Background information: The Health and Human Services Commission (HHSC) received notice that the COVID-19 federal public health emergency (PHE) declared on January 31, 2020, will end on May 11, 2023. In response to the PHE, TCHP implemented additional flexibilities during this time that will come to an...

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