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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QW Modifier Update and Claims Reprocessing for Procedure Code 87521

Date: January 25, 2025

Attention: All Providers

Effective for dates of service on or after June 27, 2024

Call to action: The purpose of this communication is to information providers that effective for dates of service on or after June 27, 2024, procedure code 87521 (Infectious Agent Antigen Detection) will require the QW modifier. Claims submitted with procedure code 87521 for dates of service from June 27, 2024, through October 3, 2024, may be reprocessed.

How this impacts providers: The reprocessed claims may result in additional payment that will be reflected on future Remittance and Status (R&S) Reports.

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

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

For access to all provider alerts: https://www.texaschildrenshealthplan.org/provideralerts