Abatacept (Orencia) Information Updated in TMPPM Outpatient Drug Services Handbook

Date: June 9, 2025

Attention: All Providers

Effective Date: July 1, 2025

Call to action: On July 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual, Outpatient Drug Services Handbook, section 6.1, “Abatacept (Orencia).” TMHP will add the following information about the drug and its age requirements:

• Abatacept (Orencia) (procedure code J0129) is a selective T-cell costimulation modulator.
• The age limitation for psoriatic arthritis is 2 years of age or older.

Next steps: Providers are encouraged to 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,log into:
www.texaschildrenshealthplan.org/provideralerts.