Provider Alert! COVID-19 At-home Test Kits Available as a Pharmacy Benefit
Date: January 4, 2022
Attention: All Providers
Effective date: January 3, 2022
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: HHSC will allow COVID-19 at-home test kits as a Medicaid and Children’s Health Insurance Program (CHIP) pharmacy benefit beginning January 3, 2022. Members may obtain COVID-19 at-home test kits from a Medicaid-enrolled retail pharmacy with or without a prescription from a prescribing provider. Texas Childrens Health Plan will allow for a maximum quantity of 4 tests per calendar month. Prescriptions can be processed using single packs (1 test) or multi-pack test kits (2 tests), equaling a total of 4 at-home COVID-19 tests per month. As an example:
- 1 single-pack kit (1 test) – allows 4 kits per calendar month
- 1 multi-pack kit (2 tests) – allows 2 kits per calendar month
How this impacts providers: When prescribing a COVID-19 test kit, the prescribed quantity and any applicable refills may not exceed the benefit limit of 4 tests per calendar month.
List of Allowable Test Kits
| COVID-19 Test-Kit Name | NDC | Package Size |
| InteliSwab COVID-19 Rapid Test | 08337-0001-58 | 2 tests |
| QuickVue At-Home OTC COVID-19 Test | 14613-0339-37 | 1 test |
| QuickVue At-Home OTC COVID-19 Test | 14613-0339-72 | 2 tests |
| BinaxNOW COVID-19 AG Card | 11877-0011-29
|
1 test |
| BinaxNOW COVID-19 AG Card Home Test | 11877-0011-33
|
1 test |
| BinaxNOW COVID-19 AG Self Test | 11877-0011-40 | 2 tests |
| Everlywell COVID-19 Test Home Collection Kit DTC | 51044-0008-42 | 1 test |
Next steps for providers: Prescribers should communicate these changes to their staff.
If you have any questions, please email Provider Network Management at: TCHPPharmacy@texaschildrens.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers
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