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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Reminder: NPI Requirement for Service Facility Location on Claims

Date: May 30, 2025

Attention: Providers

Call to action: This communication serves as a reminder of the National Provider Identifier (NPI) requirement for the service facility location, as outlined in the Texas Medicaid Provider Procedures Manual (TMPPM),  Section 6: Claims Filing, TMPPM, 6.2.3, ​Claims Filing InstructionsPer the TMPPM:

“Facility Provider field blank or invalid. When place of service (POS) is anywhere other than home or office, the facility’s NPI must be present. If the NPI is not known, enter the name and address of the facility. Consult the software vendor for this field’s location on the electronic claims entry form.”

How this impacts providers: Claims submitted without the service facility NPI number in loop 2310C (CMS-1500) will be rejected at the clearinghouse level.

Next step for Providers: Providers must ensure compliance with this NPI requirement. Please work with your clearinghouse or billing software vendor to confirm that the NPI is correctly captured and submitted.

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

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