Provider Network News
Prior Authorization Updates, Effective: May 30, 2024
Vaccine Services Procedure Code 90623 is Now Available Through TVFC Effective April 1, 2024
Chikungunya Virus Vaccine Is Now a Benefit of Texas Medicaid
Billing Electronic Visit Verification (EVV) Services as Secondary Insurance Claim
PCHP Provider Claim Appeal process effective May 1, 2024
RSV Vaccine Procedure Code 90678 is Now a Benefit for Pregnant Individuals Effective October 1, 2023
PCHP Policy Update to Claim Rejections: Enrollment Mismatch to TMHP Enrollment Broker
PCHP 2024 Prior Authorization Updates – Effective 4/1/2024
Change Healthcare: System Outage Impacting PCHP Operations
Updates to Vaccine Administration Procedure Code M201
RSV Monoclonal Antibody Nirsevimab is a Benefit of Texas Medicaid and CHIP
Health Benefit Plan Coverage of Prescription Contraceptive Drugs Finalized
Coverage of Commercialized COVID-19 Vaccines
COVID-19 Vaccine Procedure Code 91304 is Now a Benefit of Medicaid and CHIP
Telemedicine and Telehealth Benefit Updates for Rural Health Clinics and Federally Qualified Health
Prior Authorization Criteria Addition for Qalsody begins Oct 1, 2023
Vaccine Services Benefits to Change for Texas Medicaid
TX Medicaid Flu Vaccine Coverage 2023-2024 Season
Age Range Expansion for Pneumococcal 20-Valent Conjugate Vaccine
HHSC Does not cover vaccines or drugs that do not have FDA Approval
Carelon Behavioral Health To Coordinate with Other Providers
PCHP Partnership with Claris Health
Effective July 1, 2023: Verisys Facility Credentialing App Submission
COVID-19 Vaccine Administration Procedure Codes
Inpatient Prior Authorization Number
Provider Portal Newborn Notification Form
Inactive NPI in NPPES to Trigger Disenrollment Action
Infection Control Supplies Procedure Code S8301 No Longer a Benefit Effective May 12, 2023
COVID-19 Vaccine Counseling Procedure Code G3015
Co-Pays for some CHIP service will resume starting May 12, 2023
COVID-19 Vaccine Administration Procedure Codes 0124A, & 0134A
COVID-19 Vaccine Administration Procedure Codes 0164A
Diabetic Equipment and Supplies Benefits to Change
Update to Procedure Code Q0222
Update to Age Restrictions for Vaccine Procedure Codes 90671 and 90756
COVID-19 Vaccine Administration Procedure Code 0041A and 0042A
CoCM Benefit: Provider Attestation Form Effective 1/1/2023
Health Advisory: Influenza Activity in Dallas County 11/28/2022
COVID-19 Vaccine Administration Procedure Code 0044A benefit *new 10/19/2022*
EVV Cures Act Home Health Care Services Implementation Confirmed for Jan. 1, 2024
Grant PCHP Access to Your EHR/EMR for Medical Record Review, HEDIS, and ECDS Purposes
Case Management for Children & Pregnant Women (CPW) effective September 1, 2022
The Collaborative Care Model New Medicaid Benefit Effective June 1, 2022
Updates to Age Restriction for Procedure Code 90619
COVID-19 Vaccine Administration Procedure Codes
Dental Therapy Under General Anesthesia
Prior Authorizations Reprocessing
Removal of Coordination of Benefits (COB)
ABA Medicaid Benefit effective February 2022
Guidance on Asthma Education Coverage in Medicaid and CHIP
New Payment Methods Starting April 2021
PCHP Covid-19 CHIP Provider Co-pay Attestation Form 093020
90 Extension of Prior Authorizations - 07312020
PCHP Telemedicine and Telehealth_revised 07012020
813_PCHPTaxonomy_Provider 05-13-2019
ImmTrac2 - Immunization Registry - 4-15-20 mnd v2
SLP Provider Notification March 2020
PCHP Neonatal LOC Validation on Facility Claims Notice_TX 02-16-2020
Notice to Physicians and Providers Parkland 01-27-2020
Inform Providers 2012 American Dental Association Claim Form can not to be used after 12-31-2019
Lab Web Portal is Not Available by Nov 10-2019
PCHP _ Influenza Vaccine September 2019
Updated Version of the American Dental Association Claim Form Now Available 08-30-2019
F00090_Sterilization_Consent_Form April 2019 English
F00090_Sterilization_Consent_Form April 2019 Spanish
F00090_Sterilization_Consent_Form_Instructions April 2019
Reminder Changes to Sterilization Consent Form Instruc-Denial Letter Eff 04-26-2019
Providers Required to Use 2018 and 2019 American Dental Association Claim Forms by Jan 2019
PCHP Acceptable and Non Acceptable November 2018
PCHP Therapy Wait List 11-05-2018
082818-Updated Provider Information Change Form Now Available 08-28-2018
Wound Care Equipment and Supply Benefits Change 07-01-2018
HEIDIS Results CHIP 2017 released 06-27-2018
HEIDIS Results STAR 2017 released 06-27-2018
Clarification for Providers Regarding MCO Therapy Guidance 06-22-2018
PCHP Delivery Claim Billing effective Feb 1 2018 _ Update 5-17-2018
CHIP Member Eligibility Now Available via EDI HIPAA X12 270 and 271 Transaction 04-09-2018
