SNAP Update and ResourcesActualización y recursos de SNAP
On November 1, 2025, the requirements to receive and apply to the Supplemental Nutrition Assistance Program (SNAP) benefits have changed. To see the new policies to request SNAP benefits, click here and/or call 211 for SNAP assistance. Learn more
El 1 de noviembre de 2025, cambiaron los requisitos para recibir y aplicar para los beneficios del Programa de Asistencia Nutricional Suplementaria (SNAP, por sus siglas en inglés). Para consultar las nuevas políticas para aplicar para los beneficios de SNAP, haz clic aquí o llama al 211 para obtener ayuda de SNAP. Aprende Más
Transportation UpdateActualización de transporte
SafeRide Health (SRH) is the new provider for all NEMT rides to doctor appointments and pharmacy visits.
Depending on your needs, rides may include wheelchair-lift-equipped vehicles, stretcher vans, minivans, or ambulatory vans. Please let SRH know what type of ride you need when scheduling.
SafeRide Health (SRH) es el nuevo proveedor de todos los servicios de transporte médico que no son de emergencia (NEMT, por sus siglas en inglés) hacia consultas médicas y farmacias.
Según tus necesidades, los servicios de transporte pueden incluir vehículos con elevador para sillas de ruedas, camionetas con camilla, minivans o camionetas ambulatorias. Por favor, informa a SRH qué tipo de transporte necesitas al programar tu traslado.
Maximum Allowable Update for Non-Risk Based Drugs Billed With ‘Unclassified’ Procedure Codes
Date: June 12, 2024
Attention: All Providers
Call to action: The Texas Health and Human Services Commission (HHSC) would like to disclose the maximum allowable reimbursement for Non-Risk drugs currently payable under an ‘Unclassified’ procedure code as referenced in the National Drug Code to Healthcare Common Procedure Coding System (NDC to HCPCS) crosswalk.
How this impacts providers: HHSC bases the pricing for an outpatient medical claim for an ‘Unclassified’ procedure code on the lesser of the manufacturer’s suggested retail price minus 18% or Average Wholesale Price (AWP) minus 10.5%. Currently, two Non-Risk drugs are billed with the ‘Unclassified’ procedure code. The effective date and current maximum allowable reimbursement rate for Skysona and Zynteglo are in the table below.
NDC
Drug Name
Effective Date
Term Date
Drug Type
Code
Max Rate
73554211101
SKYSONA INFUSION BAG-CASSETTE
7/1/2023
12/31/9999
CAD
J3590
$3,222,000
73554311101
ZYNTEGLO INFUSION BAG-CASSETTE
7/1/2023
12/31/9999
CAD
J3590
$3,007,200
The qualified treatment center must send the prescription to the manufacturer-authorized specialty pharmacy. The pharmacy will process the claim for the drug through medical benefits using the ‘Unclassified’ procedure code.
As a reminder, HHSC limits Non-Risk payments to the actual amounts paid to providers for the drug’s ingredient cost (up to the fee-for-service reimbursement amount). TCHP requires the facility to submit an invoice.
Next step for Providers: Prescribers should share this communication with their staff. Provider must submit documentation (such as office chart notes, lab results, other pertinent clinical information, etc.) supporting that the member has met all appropriate criteria for medication approval.
