Important Update Actualización 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 Changes Cambios 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.

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New PENS Procedure Codes

Date: September 9, 2024 

Attention: All Providers

Effective date: July 1, 2024

Call to action: Texas Children’s Health Plan (TCHP) would like to inform network providers that effective for dates of service on or after July 1, 2024, percutaneous electrical nerve stimulation (PENS), procedure codes 64596, 64597, and 64598, is now a benefit when services are provided in an inpatient or outpatient hospital setting by a physician provider.

Refer to the current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, subsection 9.2.45.11 “Percutaneous Electrical Nerve Stimulation (PENS),” for additional benefit information and prior authorization requirements that apply to all PENS services. 

Next step for providers: Providers should share this update with their staff. 

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org. 

For access to all provider alerts,log into:
www.texaschildrenshealthplan.org/providers/provider-news/provider-alerts or www.texaschildrenshealthplan.org/for-providers.