Provider Alert! Age Range Updates for Drug Procedure Codes Effective April 1
Date: April 6, 2022
Attention: Providers
Effective Date: April 1, 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: On April 1, 2022, HHSC updated age ranges for drug procedure codes Q0167, Q0169, and Q0175 for Medicaid and CHIP.
How this impacts providers: Dronabinol (procedure code Q0167) and Perphenazine (procedure code Q0175) is a benefit for clients 18 years and older. Promethazine (procedure code Q0169) is a benefit for clients 2 years and older. Fee-for-service criteria for Q0167, Q0169, and Q0175 are effective on April 1, 2022. These updates will appear in the May 2022 Outpatient Drug Services Handbook chapter of the Texas Medicaid Provider Procedures Manual.
Next steps for providers: Prescribers should adjust their prescribing patterns accordingly and share this update with their staff as well
If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.
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