Provider Notices from HHSC
Prior Authorization Criteria for Anktiva Effective Nov. 1, 2024
Prior Authorization Criteria for Imdelltra Effective Nov. 1, 2024
Genetic Services Biomarker Testing Expanded Carrier Screening Criteria for Prior Authorization
Genetic Services Biomarker Testing Whole Genome Sequencing Criteria for Prior Authorization
Genetic Services Biomarker Testing Benefits for Texas Medicaid Effective September 1, 2024
Co-pays for CHIP COVID-19 services will resume starting October 1, 2024
Hepatitis C Information Letter for Prescribers to Distribute by June 14, 2024
Hepatitis C Educational Webinar for Prescribers Scheduled for June 13, 2024
Omnipod 5 Added to Medicaid, CHIP Drug Formularies On Feb. 2024
Coverage of Elevidys Begins Jan. 2024; Prior Authorization Effective Feb. 2024
Coverage of Vyjuvek Begins Jan. 2024; Prior Authorization Effective Feb. 2024
Educational Video and Infographics Now Available to Providers: Telemedicine and Telehealth Delivery
Hepatitis C Educational Webinar For Prescribers Occurs March 6, 2024
Health Benefit Plan Coverage Of Prescription Contraceptive Drugs Finalized, Implements Jan. 2024
Change in Preferred Drug List Status for the Macrolides-Ketolides Drug Class Effective Nov. 7, 2023
Prior Authorization Criteria for Leqembi Begins Nov. 1, 2023** Action Required and Informational
HTW Benefit Information Will Be Updated on November 1, 2023
Lecanemab-irmb (Leqembi) a Benefit of Texas Medicaid Effective July 6, 2023
Reimbursement Rate Updates for Drug Procedure Codes J7214 and J9345 Effective October 1, 2023
New Texas Medicaid & Healthcare Partnership (TMHP) Contracts
Collaborative Care Model (CoCM) in Texas Medicaid Billing Case Study Videos
HHSC Implements APR-DRG Grouper 40 for Inpatient FFS Provider Reimbursements
HHSC to Add Zynteglo as Medicaid and CHIP Benefit July 1, Prior
Authorization Effective Sept. 1
HHSC to Add Skysona as Medicaid and CHIP Benefit July 1, Prior
Authorization Effective Sept. 1
HHSC to Add Tzield as Medicaid and CHIP Benefit July 1, Prior Authorization Effective Aug. 1
Noninvasive Prenatal Screening Benefits to Change for Texas Medicaid July 1, 2023
HHSC Requires Pharmacies to Update Email Addresses in PEMS
Hydroxyprogesterone Caproate (Makena) Procedure Code J1726 No Longer a Benefit Effective June 1, 2023
Makena Products No Longer Covered as of April 7, 2023
COVID-19 Guidance: Fair Hearing Determination Extensions
COVID-19 Guidance: Fair Hearing Request Extensions
Update to COVID-19 Accommodations for the Member State Fair Hearing Process
Medicaid Autism Services Family Flyer: Applied Behavior Analysis Services
Collaborative Care Model (CoCM) in Texas Medicaid computer-based training (CBT)
CHIP Copay Non-Risk Payment Reimbursement Criteria
EVV Cures Act Home Health Care Services Implementation Confirmed for Jan. 1, 2024
CHIP Office Visit Co-Payments, Updated Reimbursement Process
HHSC External Medical Review (EMR) Provider Training
MCO Notice: Hurricane Ida Information For Medicaid Providers
MCO Notice: Implementation Deadline for Provider Recoupment Policy
MCO Notice: Update to COVID-19 Testing Billing
MCO Notice: 2021 HIV Prevention in Healthcare Webinar Learning Series 2
OFF CYCLE MCO Notice - June 2 2020 COVID-19 and Applicability of EPSDT for Some Adults
Thsteps-Telemedicine-Guidance-Providers May 8 2020
HHSC CARES Information Sheet April 2020
Texas Expands Opioid Misuse Prevention and Treatment Efforts
Governor Abbott Announces Approval Of 1135 Medicaid Waiver
Requests Section 1135 Waiver To Support Health Care Workforce In Medicaid Program
SLP Provider Notification March 2020