Memorial Day Holiday Horario de Días Festivos

Texas Children's Health Plan will be closed on Monday, May 26th, in observance of Memorial Day. In our absence, you can reach our after-hours nurse help line at 1-800-686-3831. We will resume normal business hours on Tuesday, May 27th. Wishing you a safe and happy Memorial Day weekend!

Texas Children’s Health Plan estará cerrado el lunes 26 de mayo por el feriado. Durante nuestra ausencia, puede comunicarse con nuestra línea telefónica de ayuda 24/7 fuera del horario de atención al 1-800-686-3831. Reanudaremos nuestro horario habitual el martes 27 de mayo. ¡Le deseamos un fin de semana festivo seguro y feliz!

Cold and flu season Temporada de influenza y resfriados

ALERT: Stay healthy this cold and flu season! Learn more

ALERTA: ¡Mantente sano durante esta temporada de influenza y resfriados! Más información

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Removal of Certain Drugs from the TMPPM

Date: May 23, 2025

Attention: All Providers

Effective Date: June 1, 2025

Call to action: The purpose of this communication is to inform providers that on June 1, 2025, Texas Medicaid & Healthcare Partnership (TMHP) will remove the following subsections from the Texas Medicaid Provider Procedures Manual (TMPPM), Outpatient Drug Services Handbook:

  • Subsection 6.18, “Brexanolone (Zulresso)” – procedure code J1632 will no longer have a rebate-eligible National Drug Code (NDC), effective June 1, 2025.
  • Subsection 6.77, “Lefamulin (Xenleta)” – procedure code J0691 currently does not have a rebate-eligible NDC.
  • Subsection 6.91, “Moxetumomab Pasudotox-tdfk (Lumoxiti)” – procedure code J9313 will no longer have a rebate-eligible NDC, effective June 1, 2025.

These drugs are not covered on the Texas Medicaid benefit.

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.