Monthly Archives - May 2024

Provider Alert!
16May

Provider Alert! EVV PSO 2024 Onboarding Schedule and Enrollment Available on TMHP EVV Proprietary Systems Webpage

Date: May 16, 2024 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers Call to action: Texas Children’s Health Plan would like to inform program providers, financial management services agencies (FMSAs), and Consumer Direct Services (CDS) employers that that Texas Medicaid & Healthcare Partnership (TMHP) has published the Proprietary System Operator (PSO) 2024 Onboarding schedule to the EVV Proprietary Systems webpage. HHSC is encouraging program providers and FMSAs who wish to become a PSO to submit a Proprietary System (PS) Request Form. The PS...

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Provider Alert!
16May

Provider Alert! National Drug Codes Added to Medicaid, CHIP Formularies

Date: May 16, 2024 Attention: Providers Effective date: May 8 and May 10, 2024 Call to action: Texas Children’s Health Plan would like to inform providers that the Vendor Drug Program added the new drugs to the table available below, effective May 8, 2024, and May 10, 2024. National Drug CodeDrug NameEffective Date00173090442NUCALA 40 MG/0.4 ML SYRINGE5/8/202415370030560POKONZA 10 MEQ PACKET5/8/202464406003002ZURZUVAE 25 MG CAPSULE5/10/202464406003101ZURZUVAE 30 MG CAPSULE5/10/202468682013350CLINDAMYC-BNZ PEROX 1.2-3.75/10/202472786010202OXBRYTA 300 MG TABLET5/10/202472786010203OXBRYTA 300 MG TABLET5/10/202472205018138PIRFENIDONE 267 MG TABLET5/10/202459651020623NITROFURANTOIN 25 MG/5 ML SUSP5/10/202400173089713JESDUVROQ 1 MG TABLET5/10/202400173090313JESDUVROQ...

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Provider Alert!
14May

Provider Alert! Chikungunya Virus Vaccine Is Now a Benefit of Texas Medicaid

Date: May 14, 2024 Attention: All Providers Effective Date: April 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after April 1, 2024, the chikungunya virus vaccine (procedure code 90589) is now a benefit of Texas Medicaid for clients who are 19 years of age or older. Procedure code 90589 may be reimbursed for the following provider types and places of service: Place of ServiceProvider TypeOfficePhysicians, Physician assistants, nurse practitioners, clinical...

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Provider Alert!
14May

Provider Alert! Vaccine Services Procedure Code 90623 is Now Available Through TVFC

Date: May 14, 2024 Attention: All Providers Effective Date: April 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after April 1, 2024, vaccine services procedure code 90623 is now available through the Texas Vaccines for Children (TVFC) program for clients who are 10 years through 18 years of age. Note: Procedure codes for vaccines distributed by the Texas Vaccines for Children Program are processed as Informational on Texas Medicaid fee-for-service...

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Provider Alert!
09May

Provider Alert! Change in Preferred Drug List Status for Lincosamides/Oxazolidinones/Streptogramins Drug Class

Date: May 9, 2024 Attention: All Providers Effective date: May 7, 2024 Call to action: Effective May 7, 2024, the Texas Health and Human Services (HHS) removed non-preferred status from generic linezolid suspension products. This is in response to the long term back order of the brand product Zyvox by the manufacturer. The preferred status of the brand name Zyvox will not change to allow any current stock to be used. How this impacts providers: The change will allow providers to prescribe the generic without...

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Provider Alert!
08May

Provider Alert! You’re Invited to Our Provider Advisory Group! 

Date: May 8, 2024 Attention: All Providers Event dates for the upcoming sessions are based on Service Delivery Area: Tuesday, June 18, 2024 Northeast SDAThursday, June 20, 2024 Jefferson SDATuesday, June 25, 2024 Harris SDAAll sessions will be from 12:00-1:30PM CST Call to action: Texas Children’s Health Plan (TCHP) invites you to join our quarterly Provider Advisory Group (PAG). We will hold our next round of sessions next month and dates are based on Service Delivery Area as described above. Click here if you...

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Provider Alert!
07May

Provider Alert! Prior Authorization Update for Incontinence Supplies Procedure Code A6250

Date: May 7, 2024 Attention: All Providers Effective: April 10, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers of a prior authorization update for incontinence supplies procedure code A6250, skin sealants, protectants, moisturizers, and ointments, any type, any size. Procedure code A6250 is indicated to treat the following: Incontinence-associated dermatitis Effective April 10, 2024, prior authorization is required for procedure code A6250 for members 0-3 years of age. Providers can review prior authorization criteria and additional information regarding procedure code A6250...

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Provider Alert!
03May

Provider Alert! Texas Children’s Health Plan Highlights Behavioral Health Awareness Month

Date: May 3, 2024 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) is highlighting May as Behavioral Health Awareness Month and offering a Continuing Medical Education (CME) course: Advancing Mental and Behavioral Health in Primary Care: Strategies for Diagnosis, Treatment, and Coordination, to commemorate this occasion. Time and location: Date: Thursday, May 16, 2024 Time: 5:30PM-7:30PM CST Location: Virtual Event (Held via Webex) Registration: Click here to visit the webpage and registeror visit https://www.texaschildrenshealthplan.org/cme. Behavioral Health ResourcesTCHP offers provider resources for assistance with taking care...

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Provider Alert!
02May

Provider Alert! First Quarter 2024 HCPCS

Date: May 2, 2024 Attention: All Providers Effective Date: April 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that Texas Medicaid & Healthcare Partnership (TMHP) implemented the first quarter 2024 Healthcare Common Procedure Coding System (HCPCS) additions, revisions, and discontinuations, which will be effective for dates of service on or after April 1, 2024. How this impacts providers: The following drug procedure codes will be added as Medicaid benefits effective April 1, 2024: First Quarter 2024 HCPCS Added...

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