Tag - medicaid

Provider Alert!

Provider Alert! Services Submitted with Modifier GZ will be Denied for Texas Medicaid Providers

Date: August 31, 2021 Attention: Primary Care 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: Effective for dates of service on or after July 1, 2020, claims submitted for services with Modifier GZ for Texas Medicaid will be denied. [...]

Provider Alert!

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 [...]

Provider Alert!

Provider Alert! Lung Cancer Screening Benefits to Change for Texas Medicaid

Date: August 13, 2021 Attention: 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: Effective for dates of service on or after September 1, 2021, lung cancer screening benefits will change for Texas Medicaid. Major changes to this medical [...]

Provider Alert!

Provider Alert! Vaxelis Vaccine Series to Become Available for Texas Medicaid

Date: June 30, 2021 Attention: Primary Care 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: Texas Children’s Health Plan (TCHP) would like to inform providers of a new vaccine available for Medicaid Members. How this impacts providers: Vaxelis, a three-dose [...]

Provider Alert!

Provider Alert! Amondys 45 Becomes a Benefit for Medicaid and CHIP

Attention: Neurologists Effective Date: June 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: Texas Children’s Health Plan would like to inform providers of a new benefit effective June 1, 2021. The Health and Human Services Commission (HHSC) will cover Amondys 45 under [...]

Provider Alert!

Provider Alert! After hours Codes Reminder

Date: May 14, 2021 Attention: PCPs and Urgent Care Facilities 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 remind providers of Medicaid After-Hours Procedure Codes that do not require prior authorization. How this impacts providers: Below are the Medicaid Payable After-Hours [...]

Provider Alert!

Provider Alert! Colorectal Cancer Screening Benefit Criteria to Change for Texas Medicaid

Attention: PCPs and Oncologists Effective Date: March 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 March 1, 2021, colorectal cancer screening benefit criteria will change for Texas Medicaid. Fecal occult blood tests, multi-targeted stool [...]

Provider Alert!

Provider Alert! Medical Physics Consultations to Become Benefits of Texas Medicaid

Attention: Oncologists Effective Date: March 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 March 1, 2021, medical physics consultations (procedure codes 77336 and 77370) will become benefits of Texas Medicaid. Medical physics consultations will [...]

Provider Alert! Medicaid, STAR Kids, CHIP, and CHIP Perinatal eligibility during COVID-19

Date: July 23, 2021 Attention: All providers Subject: Medicaid, STAR Kids, CHIP, and CHIP Perinatal eligibility during COVID-19 Effective Date: July 22, 2021 For STAR Kids Age Outs that complete their transitions August 1, 2021. The content in this message on STAR Kids Age-Outs that transitioned on April 1, 2020 will remain in effect through July 31, 2021. Individuals ageing out starting May 1, 2021 are following normal timelines and processes, as announced by the Health and Human Services Commission. TCHP COVID-19 Utilization Management [...]

Provider Alert!

Provider Alert! Immobilized Lipase Cartridges to Become a Benefit of Texas Medicaid

Attention: All Providers Effective Date: March 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: Texas Children’s Health Plan (TCHP) would like to inform network providers that effective for dates of service on or after March 1, 2021, immobilized lipase cartridges (procedure code [...]