Tag - Glucose Monitor

Provider Alert!

Provider Alert! Prior Authorization Update for Continuous Glucose Monitoring

Date: April 20, 2021 Attention: All Providers Effective Date: April 20, 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 Children’s Health Plan would like to inform network providers that short-term continuous glucose monitoring service Procedure Codes 95250 and 95251 will require prior authorization effective...

Provider Alert!

Provider Alert! Therapeutic Continuous Glucose Monitors Become Benefit of Texas Medicaid

Attention: Primary Care Providers and Endocrinologists  Effective Date: April 1, 2020 Call to action: Texas Children’s Health Plan (TCHP) supports Texas Medicaid Health Partnership’s (TMHP) decision to include therapeutic continuous glucose monitors (CGM) as a benefit for Texas Medicaid recipients.  A therapeutic CGM device requires prior authorization and is used as a replacement for self-blood glucose monitoring (SBGM). Members who have Type I or Type II diabetes may be considered for therapeutic CGM. All of the following medical necessity criteria must be met. The...