Flu Season Alert!Alerta de temporada de influenza:
Don’t let germs win this season – protect yourself and your family!
The flu vaccine is your best defense against flu and related complications – PLUS, it is a covered benefit for Texas Children’s Health Plan members! Learn more!
¡No permitas que los gérmenes ganen esta temporada! ¡Protégete a ti y a tu familia!
La vacuna contra la influenza es tu mejor defensa contra la influenza y sus complicaciones. Además, ¡es un beneficio cubierto para los miembros de Texas Children's Health Plan! Aprende más
Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers
Call to action: Texas Children Health Plan (TCHP) would like to remind providers that beginning September 1 2025, the Texas Health and Human Services Commission (HHSC) will transition Medicaid-only services for dually eligible clients (clients who are eligible for both Medicare and Medicaid) enrolled in Medicaid managed care from a fee-for-service (FFS) to a managed care service delivery system.
Provider Responsibilities
Providers must update authorizations in their Electronic Visit Verification (EVV) System for Rider 32 services requiring an EVV visit that are transitioned from TMHP to TCHP for payment. Providers must submit claims for EVV Required Medicaid-only services for dual eligible clients enrolled in Medicaid managed care directly to TMHP for EVV claim matching.
TMHP will forward these claims to TCHP with the EVV claims matching results.
TMHP will no longer pay these claims.
Providers should contact TCHP directly for claim status updates and questions related to adjudication.
For reference, the EVV Service Bill Codes Tables are listed below:
