If you are a Texas Children’s Health Plan Member, we have tips that can help you deal with the severe weather, click here.
Recursos para Miembros Durante el Clima Severo
Si eres miembro de Texas Children’s Health Plan, tenemos consejos que pueden ayudarte a lidiar con el clima severo. Haga clic aquí.
Important UpdateActualización importante:
Good news! All CHIP, STAR, and STAR Kids Member Handbooks are now available online. Quick, easy access to your benefits and coverage information - any time!
¡Buenas noticias! Todos los manuales para miembros de CHIP, STAR y STAR Kids ya están disponibles en línea. Obtén acceso rápido y sencillo a la información sobre tus beneficios y cobertura, ¡en cualquier momento!
Medicaid Preferred Drug List and Formulary ChangesCambios en el formulario y la lista de medicamentos preferidos de Medicaid
The Vendor Drug Program (VDP) made changes to the Texas Medicaid drug formulary effective July 24, 2026. To learn more about formulary changes impacted, please click here for more information.
El programa de medicamentos de proveedores de Texas (VDP) ha realizado cambios recientes en el formulario de medicamentos de Medicaid de Texas. Esto entrará en vigencia el 24 de julio de 2026. Para obtener más información sobre los cambios en el formulario afectados, visite el siguiente enlace para obtener más información.
Telemedicine and Telehealth Benefit Updates for Rural Health Clinics and Federally Qualified Health Centers Effective November 1, 2023
Date: November 7, 2023
Attention: Rural Health Clinics and Federally Qualified Health Centers
Effective date: November 1, 2023
Call to action: The purpose of this communication is to provide guidance on the implementation of a new telehealth patient site facility fee benefit for federally qualified health center (FQHC) and rural health clinic (RHC) providers.
How this impacts providers: Effective for dates of service on or after November 1, 2023, FQHC and RHC providers performing patient-site telehealth services may be reimbursed for the facility fee (procedure code Q3014) as an add-on procedure code.
Procedure code Q3014 will be a benefit for FQHC and RHC providers when telehealth services are rendered in the office or outpatient hospital setting.
Additional information:
For FQHCs-the facility fee should not be included in any cost reporting that is used to calculate a prospective payment system (PPS) or alternative prospective payment system (APPS) per visit encounter rate.
For RHCs-the facility fee should not be included in any cost reporting that is used to calculate the RHC All Inclusive Rate (AIR) PPS per visit encounter rate.
More than one facility fee for the same client on the same date of service may be reimbursed for multiple distant-site provider consultations, when medically necessary.
If an FQHC or RHC is eligible for the payment of both an encounter fee and a facility fee for the same client on the same date of service, the FQHC or RHC must submit a claim for the facility fee separately from the claim that was submitted for the encounter.
Clarifications for telemedicine and telehealth include that FQHC practitioners may be employees of the FQHC or contracted with the FQHC. In addition, RHC practitioners may be employees of the RHC or contracted with the RHC.
Furthermore, a distant-site provider that is located outside of state lines while rendering services is considered to be an out-of-state provider.
Texas Children’s Health Plan (TCHP) must reprocess affected claims submitted with this procedure code as a telehealth service and date of service on or after November 1, 2023.
Next step for Providers: Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete. Providers may bill TCHP retroactively for procedure code Q3014.
