Speech, Physical, and Occupational Therapy Prior Authorization Update

Date: June 23, 2021 Attention: Therapy and Primary Care Providers Effective Date: June 23, 2021Providers 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 updated TCHP prior authorization requirements. How this impacts providers: Effective June 23, 2021, the evidence of a current well child checkup will no longer be required for speech physical and occupational therapy prior authorization requests. For acute therapy prior authorization requests, a clinic visit note for an acute injury dated within 90 days is still required. As a reminder, well child visits are required for all health plan members per the Texas Health Steps Medical Checkup Periodicity Schedule: http://www.onlineordersff.com/images/pdfs/26027.pdfNext steps for providers: Providers should share this communication with their staff. For reference, here are some of the relevant provider alerts:  http://www.thecheckup.org/2018/09/03/key-changes-to-tchp-therapy-authorization-guidelines/http://www.thecheckup.org/2021/01/26/provider-alert-covid-19-disaster-declaration-alert-5-prior-authorization-adjustments/http://www.thecheckup.org/2019/09/26/provider-alert-amended-initial-and-ongoing-specialty-therapy-treatment-current-texas-health-steps-checkup-or-attestation-required/If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.