Provider Alert! Clinical Criteria for Qalsody® (procedure code C9157) effective October 1, 2023
Date: October 19, 2023 Attention: All Providers Effective Date: October 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective October 1, 2023, Texas Health and Human Services Commission (HHSC) will be implementing prior authorization criteria for Qalsody® (procedure code C9157).Qalsody® (Tofersen) is an antisense oligonucleotide indicated for the treatment of amyotrophic lateral sclerosis (ALS) in adults who have a mutation in the superoxide dismutase 1 (SOD1) gene Prior Authorization Requirements: Criteria for Initial Approval: Patient is 18...
