Flu Season Alert! Alerta de temporada de influenza:

Don’t let germs win this season – protect yourself and your family!

The flu vaccine is your best defense against flu and related complications – PLUS, it is a covered benefit for Texas Children’s Health Plan members! Learn more!

¡No permitas que los gérmenes ganen esta temporada! ¡Protégete a ti y a tu familia!

La vacuna contra la influenza es tu mejor defensa contra la influenza y sus complicaciones. Además, ¡es un beneficio cubierto para los miembros de Texas Children's Health Plan! Aprende más

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Prior authorization is no longer required for Mental Health Targeted Case Management and Mental Health Rehabilitative Services

Date: August 31, 2022      Attention: Local Mental Health Authority, Behavioral Health Providers  Effective date: August 22, 2022Providers 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 network providers that beginning August 22, 2022, a prior authorization is no longer required for Mental Health Targeted Case Management (MHTCM) and Mental Health Rehabilitative Services. How this impacts providers: This direction applies to the following services: Mental Health Targeted Case Management and Mental Health Rehabilitative Services For Mental Health Rehabilitation Services
Service CategoryProcedure CodesModifiers
Day Program for Acute NeedsH2012 
Medication Training and SupportH0034HQ: group services for adults HA/HQ: group services for child/youth
Crisis InterventionH2011HA: child/youth
Skills Training and DevelopmentH2014HQ: group services for adults HA: Individual services for child/youth HA/HQ: group services for child/youth
Psychosocial Rehabilitation ServicesH2017TD: individual services provided by RN HQ: group services HQ/TD: group services provided by RN ET: individual crisis services
  For MHTCM Procedure Code T1017 and the appropriate modifier for MHTCM:
ModifierDescription
TFRoutine Case Management
TGIntensive Case Management
HAChild/Adolescent program
HZFunded by criminal justice agency
  As a reminder, all out of network providers will require a prior authorization and when services requested are beyond the benefit limitations.   Source: https://www.tmhp.com/sites/default/files/file-library/resources/provider-manuals/tmppm/pdf-chapters/2022/2022-08-august/2_Behavioral_Health.pdf Next steps for providers: Providers should share this communication 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