Tag - medicaid
20Oct

Provider Alert! COVID-19 Vaccine Administration Code 0004A Now a Medicaid Benefit

Date: October 18, 2021 Attention: Primary Care Providers Effective Date: Dates of service on or after September 22, 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: Effective for dates of service on or after September 22, 2021, in accordance with the U.S. Food and Drug...

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Provider Alert!
20Oct

Provider Alert! Health and Human Services Commission (HHSC) Release of Autism Services Benefits

Date: October 20, 2021 Attention: Primary Care Providers and Neurologists Effective Date: February 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: Effective for dates of service on or after February 1, 2022, Autism Services, to include Applied Behavior Analysis (ABA) evaluation and treatment, will...

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Provider Alert!
01Sep

Provider Alert! Services Submitted with Modifier GZ will be Denied for Texas Medicaid Providers

Date: August 31, 2021 Attention: Primary Care Providers Effective Date: July 1, 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: Effective for dates of service on or after July 1, 2020, claims submitted for services with Modifier GZ for Texas Medicaid will be denied. Services...

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Provider Alert!
27Aug

Provider Alert! Subcutaneous Internal Cardiac Defibrillator (S-ICD) to Become a Benefit for Texas Medicaid

Date: August 25, 2021 Attention: Cardiologists Effective Date: September 1, 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: Effective September 1, 2021, subcutaneous internal cardiac defibrillator (S-ICD) procedure codes 33270, 33271, 33273, 33274, 93287, and 93290 will become a benefit for Texas Medicaid. How this impacts...

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Provider Alert!
27Aug

Provider Alert! Lung Cancer Screening Benefits to Change for Texas Medicaid

Date: August 13, 2021 Attention: Primary care Providers Effective Date: September 1, 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: Effective for dates of service on or after September 1, 2021, lung cancer screening benefits will change for Texas Medicaid. Major changes to this medical benefit...

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Provider Alert!
01Jul

Provider Alert! Vaxelis Vaccine Series to Become Available for Texas Medicaid

Date: June 30, 2021 Attention: Primary Care Providers Effective Date: July 1, 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: Texas Children’s Health Plan (TCHP) would like to inform providers of a new vaccine available for Medicaid Members. How this impacts providers: Vaxelis, a three-dose vaccine...

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Provider Alert!
04Jun

Provider Alert! Amondys 45 has added a New code- J426

Date: December 17, 2021 Attention: Neurologists Effective Date: October 1, 2021 for Code J426 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: Update effective October 1, 2021, Amondys 45 new code J1426 is allowable with prior authorization for STAR, STAR KIDS, and CHIP. Texas Children’s Health Plan...

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Provider Alert!
17May

Provider Alert! After hours Codes Reminder

Date: May 14, 2021 Attention: PCPs and Urgent Care Facilities 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: TCHP would like to remind providers of Medicaid After-Hours Procedure Codes that do not require prior authorization. How this impacts providers: Below are the Medicaid Payable After-Hours Procedure...

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Provider Alert!
02Feb

Provider Alert! Colorectal Cancer Screening Benefit Criteria to Change for Texas Medicaid

Attention: PCPs and Oncologists Effective Date: March 1, 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: Effective for dates of service on or after March 1, 2021, colorectal cancer screening benefit criteria will change for Texas Medicaid. Fecal occult blood tests, multi-targeted stool deoxyribonucleic...

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Provider Alert!
01Feb

Provider Alert! Medical Physics Consultations to Become Benefits of Texas Medicaid

Attention: Oncologists Effective Date: March 1, 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: Effective for dates of service on or after March 1, 2021, medical physics consultations (procedure codes 77336 and 77370) will become benefits of Texas Medicaid. Medical physics consultations will be...

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