Facilities

Articles with relevant information about Facilities.

Provider Alert! Procedure Codes M0222, M0223 & Q0222 for COVID-19 Treatments Added as Texas Medicaid & CHIP Benefits

Date: July 5, 2022 Attention: All Providers Effective Date: February 11, 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 February 11, 2022, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the emergency use of bebtelovimab for the treatment...

Provider Alert! COVID-19 Convalescent Plasma Benefit Modified

Date: July 5, 2022 Attention: All Providers Effective Date: December 28, 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: On February 10, 2022, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the emergency use of COVID-19 convalescent plasma with...

Provider Alert!

Provider Alert! New Collaborative Care Model Medicaid Benefit

Date: July 1, 2022 Attention: All Providers Effective Date: June 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 that the Health and Human Services Commission (HHSC) has drafted a new Medicaid medical policy for...

Provider Alert!

Provider Alert! Pegfilgrastim-cbqv (Udenyca) to be Diagnosis Restricted Effective May 1, 2022

Date: July 1, 2022  Attention: All Providers Effective Date: May 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 that effective for dates of service on or after May 1, 2022, pegfilgrastim-cbqv (Udenyca; procedure...

Provider Alert!

Provider Alert! End of Reconsideration Process for Denied services

Date: July 1, 2022 Attention: All Providers   Effective date: August 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to...

Provider Alert!

Provider Alert! Tezspire (Tezepelumab-ekko) Update Effective July 1

Date: June 28, 2021 Attention: All Providers Effective Date: July 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to appeal...

Provider Alert!

Provider Alert! Treatment Indications to Change for Ferric Carboxymaltose

Date: June 17, 2022 Attention: All Providers Effective Date: July 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to appeal...

Provider Alert!

Provider Alert! Prior authorization criteria for Voxzogo (Vosoritide)

Date: June 15, 2022 Attention: All Providers Subject: Prior authorization criteria for Voxzogo (Vosoritide) Effective Date: July 15, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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: Effective July 15, 2022, Texas Children’s Health Plan (TCHP) will implement the Voxzogo clinical edit in-line with the Health and...

Provider Alert!

Provider Alert! Respiratory Syncytial Virus (RSV) Prophylaxis Season Reopening in All Regions

Date: June 15, 2022 Attention: All Providers Subject: Respiratory Syncytial Virus (RSV) Prophylaxis Season Reopening in All Regions Effective Date: June 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: Texas Children’s Health Plan (TCHP) would like to inform providers that the Health and Human Services Commission...

Provider Alert!

Provider Alert! Prior Authorization Criteria Update for Aduhelm Begins July 1

Date: June 15, 2022 Attention: All Providers Subject: Prior Authorization Criteria Update for Aduhelm Begins July 1 Effective Date: July 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: Texas Children’s Health Plan (TCHP) would like to inform providers that the Health and Human Services Commission...