Monthly Archives - March 2021

Provider Alert!
31Mar

Provider Alert! New Online Provider Directory Platform

Date: July 12, 2021 Attention: All Providers Effective Date: May 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 our network providers that beginning May 1, 2021, there will be a new online provider directory platform....

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Provider Alert!
30Mar

Provider Alert! Genetic Testing Prior Authorization Requirement Reminder

Date: March 26, 2021 Attention: All Providers 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 remind network providers that all genetic testing requires an approved prior authorization before the laboratory tests can be completed. Quest Diagnostics is...

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Provider Alert!
26Mar

Provider Alert! Clinical Prior Authorization Updates for Epidiolex

Date: March 26, 2021 Attention: Neurologists Effective Date: May 11, 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 May 11, 2021, the Texas Health and Human Services Commission (HHSC) will update the ICD-10 diagnosis codes for Epidiolex (cannabidiol) for consistency with diagnosis codes...

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Provider Alert!
25Mar

Provider Alert! Clinical Prior Authorization Updates for Cytokine and CAM Antagonist Agents

Date: March 25, 2021 Attention: Gastroenterologists, Rheumatologists Effective Date: May 4, 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 May 4, 2021, the Texas Health and Human Services Commission (HHSC) will update the cytokine and cell-adhesion molecule (CAM) antagonist agents prior authorization criteria...

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Provider Alert!
24Mar

Provider Alert! Asthma Education Coverage and Benefits

Date: March 23, 2021 Attention: PCPs and Pulmonologists 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 remind providers of Medicaid and CHIP coverage of asthma education. How this impacts providers: Asthma education and benefits for Medicaid are covered...

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Provider Alert!
24Mar

Provider Alert! Update to Renal Dialysis Revenue Codes Eligible for Reimbursement

Date: March 24, 2021 Attention: PCPs and Nephrologists Effective Date: March 23, 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 make network providers aware of updates for some of the renal dialysis revenue codes. How this impacts providers:...

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Provider Alert!
24Mar

Provider Alert! Telemonitoring Benefits to Change for Texas Medicaid March 1, 2021

Date: March 24, 2021 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 of the recent telemonitoring benefits change for Texas Medicaid effective for dates of service on...

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23Mar

Provider Alert! Reminder – Updated- Approved in-office lab list

Date: September 9, 2021 Attention: All Providers Effective date for procedure code 83655, lead screening: June 22, 2021 Call to action: Texas Children’s Health Plan (TCHP) utilizes Quest Diagnostics as our exclusive reference lab provider. This alert is to serve as a reminder of the specific labs on our pre-approved list that may be run in a network provider’s office. How this impacts providers: Providers may perform specific lab tests in their office and receive reimbursement from TCHP. All other lab tests must be...

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22Mar

Provider Alert! COVID-19 Monoclonal Antibody Therapy Procedure Code Update

Date: July 19, 2021 Attention: All Providers Effective Date for Procedure code Q0244 is June 3, 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 Texas Medicaid has revoked the Emergency Use Authorization (EUA) of...

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Provider Alert!
18Mar

Provider Alert! Diabetes Awareness and Wellness Network (DAWN) Center

Date: March 18, 2021 Attention: Primary Care Providers and Endocrinologists 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) is happy to announce that we have partnered with the Diabetes Awareness and Wellness Network (DAWN) Center to serve as a viable...

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