Appointment Availability Standards for Specialty Care and Behavioral Health

What are appointment availability standards? How do you as a provider with Texas Children’s Health Plan play a role?

• In 2015 Senate Bill 760 passed, requiring Texas Health and Human Services Commission (HHSC) to monitor the provider networks of managed care organizations. Texas Children’s Health Plan would like to ensure members are able to schedule appointments with providers in accordance with the HHSC’s appointment accessibility guidelines.

  PLEASE NOTE: Specialist visits do not require primary care provider (PCP) referral.