Benefit Changes Prior Authorization Update

Attention: All Texas Children’s Health Plan ProvidersSubject: UPDATE to Changes for Physical, Occupational, and Speech Therapy Benefits   Prior Authorization Changes Update Changes to TCHP Prior Authorizations for PT, OT, and ST services:

• For therapy authorizations with approved dates of service spanning the 9/1 transition date, TCHP created a revised authorization in our system that reflects the new billing structure using the same authorization number.
• For all therapy requests that were submitted prior to 9/1, the revised authorization will start on 9/1 and cover through the end of the authorized period. Providers will not need to change their authorization reference number for claims submission.
• Providers should bill according to correct billing structure for the date of service. There is no further action required from providers.
• TCHP will continue to prefer the Texas Standard Prior Authorization form available on our website for Therapy requests.

https://www.texaschildrenshealthplan.org/sites/default/files/pdf/Prior%20Authorization%20Requirements_JUNE%202018.pdf   Please utilize the Utilization Management Authorization fax line for the following services:

• Medical Services 832-825-8760 or Toll Free 844-473-6860
• Behavioral Health Services 832-825-8767 or Toll Free 844-291-7505