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
Call to action: The purpose of this communication is to offer information about the Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) prior authorization updates.
How this impacts providers: Effective January 1, 2024 Texas Children’s Health Plan’s (TCHP's) prior authorization updates are listed below. These changes follow guidance from Texas Medicaid and Healthcare Partnership (TMHP). Medical necessity criteria for utilization review will be in accordance with Texas Medicaid Provider Procedure Manual (TMPPM).
The following CPT codes REQUIRE prior authorization effective 1.1.2024:
J1304 (Toferson, inj, 1mg)
E0733 (Transcutaneous Nerve Stim-Trigeminal)
L5926 (Prosthesis-above knee)
The following CPT codes DO NOT REQUIRE prior authorization effective 1.1.2024:
