Prior Authorization Reference Information

The Texas Children’s Health Plan website now has an additional resource for information related to prior authorization requirements. The Prior Authorization Reference Information documents the codes that require authorization for payment based on authorization category. This list is not yet all-inclusive. It can be found at: https://www.texaschildrenshealthplan.org/sites/default/files/pdf/PA%20Code%20List%20December%202018.pdf In addition, providers can submit an authorization request online for the codes listed on the Prior Authorization Reference Information document via Clear Coverage. For access to or training on the use of Clear Coverage, contact your Provider Relations representative at 832-828-1004. A list of all services that require authorization can be found at: https://www.texaschildrenshealthplan.org/sites/default/files/pdf/Prior%20Auth%20Requirements_NOV%202018.pdf