Texas Children's Health Plan will be closed on Thursday, December 25th and Thursday, January 1st in observance of the holidays. In our absence, you can reach our after-hours nurse help line at 1-800-686-3831. We will resume normal business hours on Friday, January 2nd. Wishing you a safe and happy holiday season!
Texas Children’s Health Plan estará cerrado el jueves 25 de diciembre y el jueves 1 de enero en observancia de los días festivos. Durante este tiempo, puede comunicarse con nuestra línea de ayuda de enfermería fuera del horario de atención al 1-800-686-3831. Reanudaremos nuestro horario normal de atención el viernes 2 de enero. ¡Le deseamos una temporada de fiestas segura y feliz!
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.
Texas Medicaid Now Participates in the Cell and Gene Therapy Access Model
Date: September 10, 2025
Attention: Hematologists
Effective date: September 1, 2025
Call to action: Texas Children’s Health Plan (TCHP) would like inform providers that on September 1, 2025, Texas Medicaid began to use the Cell and Gene Therapy (CGT) Access Model that was implemented by the Centers for Medicare & Medicaid Services (CMS) Innovation Center.
The CGT Access Model focuses on the following gene therapies for sickle cell disease:
Lyfgenia by bluebird bio
Casgevy by Vertex Pharmaceuticals
These therapies require chemotherapy, which may affect a client’s fertility. Under this model, clients can receive fertility preservation services that are not normally covered by Texas Medicaid. The cost of these fertility preservation services will not be billed to Medicaid or providers – drug manufacturers (bluebird bio and Vertex Pharmaceuticals) will cover the full cost.
Billing process for gene therapies:
Providers must be enrolled with the CMS Designated Registry through the Center for International Blood and Marrow Transplant Research (CIBMTR) before administering the therapy.
Providers must also participate in the CMS study linked to the model (details provided directly from CIBMTR).
Claims must follow the billing requirements in the Texas Medicaid Provider Procedures Manual (TMPPM), including “Separate Reimbursement of Certain Inpatient HCCADs” and “HCCADS Claims Processing Requirements.”
Providers must submit the invoice of the actual acquisition cost of the drug.
Next steps: Providers can find more information about gene therapies, eligibility, claims submission, and related services on the Texas Vendor Drug Program website. Please share this information with your staff.
