Labor Day Holiday Día del Trabajo

Texas Children's Health Plan will be closed on Monday, September 1st, in observance of Labor 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, September 2nd. Wishing you a safe and happy Labor Day!

Texas Children's Health Plan estará cerrado el lunes 1 de septiembre por el Día del Trabajo. Durante nuestra ausencia, puedes comunicarse con nuestra línea telefónica de ayuda fuera del horario habitual al 1-800-686-3831. Reanudaremos nuestro horario regular el martes 2 de septiembre. ¡Te deseamos un feliz y seguro Día del Trabajo!

New Rewards Coming Soon! ¡Se vienen nuevas recompensas!

Our Healthy Rewards Program is getting an update in September! For a sneak peek of all the changes - including new rewards and ways to redeem them - please click here.

¡Nuestro Programa Healthy Rewards tendrá su actualización en septiembre! Para ver un adelanto de todos los cambios, incluyendo nuevas recompensas y formas de canjearlas, haz clic aquí.

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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.