Provider Alert! New prior authorization requirements for Teprotumumab-trbw (Tepezza)
Attention: Ophthalmologists and Endocrinologists Effective Date: January 19, 2021 Call to action: Texas Children’s Health Plan (TCHP) is aligning prior authorization criteria for teprotumumab-trbw (Tepezza), J3241 (formerly procedure code C9061), with the Texas Medicaid Provider Procedures Manual (TMPPM). Tepezza is a clinician administered drug indicated for members with thyroid eye disease (TED). Below are the new prior authorization criteria for TCHP members effective 1/19/2021. For initial therapy, ALL of the following criteria must be met: A diagnosis of Graves’ disease (diagnosis code...