New PENS Procedure Codes

Date: September 9, 2024 

Attention: All Providers

Effective date: July 1, 2024

Call to action: Texas Children’s Health Plan (TCHP) would like to inform network providers that effective for dates of service on or after July 1, 2024, percutaneous electrical nerve stimulation (PENS), procedure codes 64596, 64597, and 64598, is now a benefit when services are provided in an inpatient or outpatient hospital setting by a physician provider.

Refer to the current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, subsection 9.2.45.11 “Percutaneous Electrical Nerve Stimulation (PENS),” for additional benefit information and prior authorization requirements that apply to all PENS services. 

Next step for providers: Providers should share this update 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/providers/provider-news/provider-alerts or www.texaschildrenshealthplan.org/for-providers.