Provider Alert! Speech, Physical, and Occupational Therapy Prior Authorization Update
Date: June 23, 2021
Attention: Therapy and Primary Care Providers
Effective Date: June 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 inform providers of updated TCHP prior authorization requirements.
How this impacts providers:
Effective June 23, 2021, the evidence of a current well child checkup will no longer be required for speech physical and occupational therapy prior authorization requests. For acute therapy prior authorization requests, a clinic visit note for an acute injury dated within 90 days is still required.
As a reminder, well child visits are required for all health plan members per the Texas Health Steps Medical Checkup Periodicity Schedule:
Next steps for providers: Providers should share this communication with their staff.
For reference, here are some of the relevant provider alerts:
If you have any questions, please email Provider Network Management at: firstname.lastname@example.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.