Provider Alert! Prior Authorization Updates for Neurostimulators and Neuromuscular StimulatorsTexas Children's Health Plan
Date: July 18, 2023
Attention: All Providers
Effective date: July 1, 2023
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers of a new prior authorization requirement effective July 1, 2023, for neurostimulators and transcutaneous electrical supply- CPT Code A4560.
How this impacts providers: This prior authorization requirement aligns with the TMPPM and applies to all lines of business CHIP, STAR, and STAR Kids. There is a limit to one unit every 12 weeks or four units per year.
Next step for Providers: Providers should share this communication with their staff and follow the guidance outlined here.
If you have any questions, please email Provider Relations at: firstname.lastname@example.org.
For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.