Date: August 22, 2025
Attention: All Providers
Call to action: To ensure that Texas Medicaid clients continue to receive uninterrupted care during the 2025 Texas flooding response, the Texas Health and Human Services Commission (HHSC) has directed the Texas Medicaid & Healthcare Partnership (TMHP) to extend existing fee-for-service prior authorizations by 90 days. This statewide extension applies to prior authorizations that require recertification and are set to expire between July 2, 2025, and September 29, 2025.
TMHP will also identify all affected claims for reprocessing. Any resulting reimbursements will appear in future Remittance and Status (R&S) Reports.
Prior Authorization Extension Requests
TMHP will only approve prior authorization extension requests from Texas Medicaid providers affected by the recent flooding. Texas Medicaid clients who wish to submit extension requests must contact their providers to initiate a request.
Note: When submitting prior authorization extension requests, providers must:
- Clearly state that the need is a result of the 2025 Central Texas floods.
- Include an explanation for needing an extension.
The extended prior authorizations will contain the same proportional amount and frequency as TMHP originally approved. These extensions do not apply to:
- Current authorizations for one-time services.
- Pharmacy prior authorizations.
- Nursing facility services.
For example, TMHP will not grant an extension for a single non-emergency ambulance trip, but a recurrent non-emergency ambulance authorization for dialysis would be extended.
TMHP will follow current guidelines for all new prior authorization requests, and the requests will not be eligible for the 90-day extension.
Providers can use TMHP’s Prior Authorization (PA) on the Portalto check the status of their prior authorization requests. For guidance, refer to the “Status” section of the Prior Authorization (PA) on the Portal Submission Guide. The guide is available on TMHP’s Prior Authorization web pageunder “Helpful Links” and on theTMHP Learning Management Systemwebsite.
Next steps: Providers should share this communication with their staff.
Additional Resources
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.
