Increase in Pertussis Aumento de casos de tos ferina

Texas is reporting a significant increase in cases of pertussis, also known as whooping cough, in 2025. More than 3,500 cases have been reported in Texas through October this year alone. Learn more

Texas está reportando un aumento significativo de casos de tos ferina, también conocida como tos convulsa, en 2025. Solo en octubre de este año, se han reportado más de 3500 casos en Texas. Aprender más

Infant Formula Recall Retirada del mercado de fórmula infantil

ALERT: ByHeart Recalls Whole Nutrition Infant Formula. Read more

AVISO IMPORTANTE: ByHeart retira del mercado su fórmula infantil Whole Nutrition. Aprender más

Transportation Update Actualización de transporte

Starting December 15, 2025, SafeRide Health will become the new provider for all member rides to doctor appointments and pharmacy visits. After this date, Texas Children’s Health Plan will no longer use MTM for Non Emergency Medical Transportation (NEMT) services.

Learn more here

For other questions, please call Member Services at the number on the back of your member ID card.

A partir del 15 de diciembre de 2025, SafeRide Health será el nuevo proveedor para todos los viajes de los miembros a citas médicas y visitas a la farmacia. Después de esta fecha, Texas Children’s Health Plan ya no usará MTM para los servicios de Transporte Médico No Urgente (NEMT).

Obtenga más información AQUI

Si tiene otras preguntas, llame a Servicios para Miembros al número que aparece en la parte posterior de su tarjeta de identificación del miembro.

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Immunosuppressive Drug Indications and Age Limitations to Be Updated for Texas Medicaid

Date: November 25, 2025

Attention: All Providers

Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after December 1, 2025, age limitations and treatment indications will be added for some immunosuppressive drugs.

Age Limitations

Texas Medicaid will limit coverage for the following immunosuppressive drugs to clients who are 18 years of age or older:

  • Alemtuzumab injection (procedure code J0202)
  • Alpha-1 proteinase inhibitor (procedure code J0257)
  • Belatacept injection (procedure code J0485)
  • Glatiramer acetate injection (procedure code J1595)

Texas Medicaid will limit coverage for the following immunosuppressive drugs to clients who are 2 years of age or older:

  • Certolizumab pegol injection (procedure code J0717)
  • Golimumab injection (procedure code J1602)

Texas Medicaid will have no age restriction for the treatment of rheumatoid arthritis with azathioprine (procedure code J7501).

Treatment Indications

On December 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM), Outpatient Drug Services Handbook, “Immunosuppressive Drugs,” to include additional indications for the following immunosuppressive drug procedure codes:

  • Certolizumab pegol injection (procedure code J0717): Treatment of rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, non-radiographic axial spondylarthritis, and plaque psoriasis
  • Golimumab injection (procedure code J1602): Treatment of polyarticular juvenile idiopathic arthritis

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

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

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