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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.

TMPPM Update: Hospital Beds and Equipment

Date: December 1, 2025

Attention: All Providers

Effective date: January 1, 2026

Call to action: Texas Children’s Health Plan (TCHP) informs providers that on January 1, 2026, the Texas Medicaid & Healthcare Partnership (TMHP) will update language in the following sections of the Texas Medicaid Provider Procedures Manual (TMPPM), Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook:

  • “Hospital Beds and Equipment”
  • “Hospital Beds”
  • “Pediatric Hospital Beds and Safety Enclosure”

Hospital Beds and Equipment

In the “Hospital Beds and Equipment” section, the updated language will include the following:

A standard bed that is typically sold as furniture may consist of a frame, box spring, and mattress, is of fixed height, and has no head or leg elevation adjustments. These types of beds are not:

  • Primarily medical in nature.
  • Made with materials that withstand frequent cleaning and disinfecting.
  • Primarily used in the treatment of disease or injury.
  • Considered durable medical equipment (DME) by Texas Medicaid.

Hospital Beds

In the “Hospital Beds” section, the updated language will include the following:

Beds that are primarily used for the purpose of safety are not a benefit of Texas Medicaid. These beds do not meet the definition of DME as described by 42 CFR § 414.202.

A hospital bed is defined as a medical device with all of the following features:

  • An articulating frame, which allows adjustment of the head and foot of the bed for the purpose of repositioning
  • A headboard
  • A foot board
  • A mattress
  • Side rails of any type (A side rail is defined as a hinged or removable rail, board, or panel of any height.)

Pediatric Hospital Beds and Safety Enclosure

In the “Pediatric Hospital Beds and Safety Enclosure” section, the following statement will be added:

A safety enclosure (procedure code E0316) is an accessory that is used in conjunction with a pediatric hospital bed or crib.

Next steps: 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: www.texaschildrenshealthplan.org/provideralerts.