Medicaid Preferred Drug List and Formulary ChangesCambios 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 January 30, 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 30 de enero de 2026
Para obtener más información sobre los cambios en el formulario afectados, visite el siguiente enlace para obtener más información
SNAP Update and ResourcesActualización y recursos de SNAP
On November 1, 2025, the requirements to receive and apply to the Supplemental Nutrition Assistance Program (SNAP) benefits have changed. To see the new policies to request SNAP benefits, click here and/or call 211 for SNAP assistance. Learn more
El 1 de noviembre de 2025, cambiaron los requisitos para recibir y aplicar para los beneficios del Programa de Asistencia Nutricional Suplementaria (SNAP, por sus siglas en inglés). Para consultar las nuevas políticas para aplicar para los beneficios de SNAP, haz clic aquí o llama al 211 para obtener ayuda de SNAP. Aprende Más
Transportation UpdateActualización de transporte
SafeRide Health (SRH) is the new provider for all NEMT rides to doctor appointments and pharmacy visits.
Depending on your needs, rides may include wheelchair-lift-equipped vehicles, stretcher vans, minivans, or ambulatory vans. Please let SRH know what type of ride you need when scheduling.
SafeRide Health (SRH) es el nuevo proveedor de todos los servicios de transporte médico que no son de emergencia (NEMT, por sus siglas en inglés) hacia consultas médicas y farmacias.
Según tus necesidades, los servicios de transporte pueden incluir vehículos con elevador para sillas de ruedas, camionetas con camilla, minivans o camionetas ambulatorias. Por favor, informa a SRH qué tipo de transporte necesitas al programar tu traslado.
Call to action: The purpose of this communication is to inform providers and their designated clearinghouses of the new custom edits scheduled to go live on November 2025. These edits will reject claims before they enter our claims adjudication system if the submitted data does not meet required standards.
How rejections will be communicated:
When a claim is rejected, you will receive a 277CA (Claim Acknowledgment) transaction with the rejection reason.
The rejection reason will be displayed in Loop 2220D, STC segment, element STC12.
The 277CA will be sent to the same entity that currently receives payer rejections today (e.g., your clearinghouse or billing service).
New edits that will cause rejections:
Billing Provider Tax ID
Billing Provider tax ID must be submitted in the correct format per 5010 requirements.
Autism Services
Autism services must be submitted with valid data elements including, CPT code, client age, rendering provider taxonomy, diagnosis code and billing provider entity type.
Zip Code
Zip Codes must be submitted in the correct format per 5010 requirements. (5-digit or 9-digit)
Invalid Frequency Code
UB04 and CMS claims must be submitted with the correct frequency code.
Patient Loop
Patient Loop 2000C is invalid and should not be submitted.
Service Facility Address
Service Facility address must be submitted with a physical address. (no PO Boxes)
Next step for Providers: Providers should share this communication with their billing staff and clearinghouse.
