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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.

Surgical Services Procedure Code 45399 to Become a Benefit of Texas Medicaid

Date: September 12, 2024 

Attention: All Providers 

Subject: Surgical Services Procedure Code 45399 to Become a Benefit of Texas Medicaid

Effective date: October 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 October 1, 2024, procedure code 45399 for surgical services for unlisted procedure, colon will become a benefit of Texas Medicaid.

How this impacts providers: Procedure code 45399 may be reimbursed for the following providers and service locations:

  • Physicians for services rendered in the hospital setting
  • Ambulatory surgical center providers and hospital-based ambulatory surgical centers in the outpatient hospital setting

TCHP does not require prior authorization for procedure code 45399.

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.