Infant Formula RecallRetirada del mercado de fórmula infantil
ALERT: ByHeart Recalls Whole Nutrition Infant Formula. Read more
AVISO IMPORTANTE: ByHeart retira del mercado su fórmula infantil Whole Nutrition. Aprender más
Transportation UpdateActualización de transporte
Starting December 15, 2025, SafeRide Health will become the new provider for all member rides to doctor appointments and pharmacy visits. After this date, Texas Children’s Health Plan will no longer use MTM for Non Emergency Medical Transportation (NEMT) services.
For other questions, please call Member Services at the number on the back of your member ID card.
A partir del 15 de diciembre de 2025, SafeRide Health será el nuevo proveedor para todos los viajes de los miembros a citas médicas y visitas a la farmacia. Después de esta fecha, Texas Children’s Health Plan ya no usará MTM para los servicios de Transporte Médico No Urgente (NEMT).
Date: July 23, 2021
Attention: All Providers
Effective Dates: August 1, 2021 and November 1, 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: Services no longer requiring a prior authorization effective August 1, 2021 include the following:
Biofeedback Codes 90901, 90912, and 90913
Durable Medical Equipment (DME) repair over 35 units
Services requiring a prior authorization for dates of service on or after August 1, 2021 include the following:
Mobility Aides Code E1035 Transfer system
Breast reduction Code 19318
Vein procedure Code 36473
Services requiring a prior authorization for dates of service on or after November 1, 2021 include the following:
Durable Medical Equipment (DME) when billed amount exceeds $500- Miscellaneous Code T199
Prosthetics Code L8610 Ocular Implant
Cerebral Seizure Monitoring – Inpatient EEG for Codes:
o 95726
o 95700
o 95718
o 95720
o 95722
o 95724
• Clinician Administered Drug Code Q2026 Dermal filler
• Functional Endoscopic Sinus Surgery inpatient/outpatient for Codes:
o 31240
o 31253
o 31254
o 31255
o 31256
o 31257
o 31259
o 31267
o 31276
o 31287
o 31288
• Gait Trainer/Standers for Code E0641
• Joint Replacement inpatient/outpatient for Codes:
o 23470
o 23472
o 23473
o 23474
o 24360
o 24361
o 24362
o 24363
o 24370
o 24371
o 27120
o 27122
o 27125
o 27130
o 27132
o 27134
o 27137
o 27138
o 27412
o 27446
o 27447
o 27486
o 27487
o 29866
o 29867
o 29868
• Spinal Surgery for Members age 21 and older, STAR only for Codes:
o 22100
o 22101
o 22102
o 22110
o 22112
o 22114
o 22206
o 22207
o 22210
o 22212
o 22214
o 22220
o 22224
o 22532
o 22533
o 22548
o 22551
o 22554
o 22556
o 22558
o 22586
o 22590
o 22600
o 22610
o 22630
o 22633
o 22800
o 22802
o 22804
o 22808
o 22810
o 22812
o 22818
o 22819
o 22830
o 22849
o 22850
o 22852
o 22855
o 22865
o 22899
o 63001
o 63003
o 63005
o 63011
o 63012
o 63015
o 63016
o 63017
o 63020
o 63030
o 63040
o 63042
o 63045
o 63046
o 63047
o 63050
o 63055
o 63056
o 63064
o 63075
o 63077
o 63081
o 63085
o 63087
o 63090
o 63101
o 63102
o 63170
o 63172
o 63173
o 63185
o 63190
o 63191
o 63194
o 63195
o 63196
o 63198
o 63199
o 63200
o 63250
o 63251
o 63252
o 63265
o 63267
o 63268
o 63300
o 63301
o 63302
o 63303
o 63304
o 63305
o 63306
o 63307
o 63308
Next steps for providers: Providers should share these prior authorization requirements with their staff.
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.
