Flu Season Alert!Alerta de temporada de influenza:
Don’t let germs win this season – protect yourself and your family!
The flu vaccine is your best defense against flu and related complications – PLUS, it is a covered benefit for Texas Children’s Health Plan members! Learn more!
¡No permitas que los gérmenes ganen esta temporada! ¡Protégete a ti y a tu familia!
La vacuna contra la influenza es tu mejor defensa contra la influenza y sus complicaciones. Además, ¡es un beneficio cubierto para los miembros de Texas Children's Health Plan! Aprende más
Update on Reimbursement for Non-Risk Criteria for COVID-19 and CHIP Copay Waiver
Date: April 11, 2025
Attention: Providers
HHSC’s Non-Risk Payments COVID-19 reimbursement will end August 31, 2025
Call to action: Texas Children’s Health Plan (TCHP) would like to update you on COVID-19 reimbursement information.
Consistent with the Centers for Medicare and Medicaid Services (CMS) guidance and the elimination of certain pandemic-related HCPCS codes, the Texas Health and Human Services Commission (HHSC) has added and removed vaccine administration and drug treatment codes from the Non-Risk payment process for both COVID-19 and CHIP copayment reimbursement criteria.
HHSC previously moved COVID-19 costs into the managed care organizations (MCO) capitation rates effective for dates of service on or after September 1, 2023. HHSC’s Non-Risk Payment (NRP) COVID-19 reimbursement will end August 31, 2025.
As stated in the May 28, 2024, MCO notice, “Reinstatement of CHIP Co-pays for COVID-19 Vaccines, Treatment, and Testing Services”, HHSC reinstated co-pays for CHIP COVID-19 vaccines, treatment and testing services on October 1, 2024. HHSC’s Non-Risk CHIP co-pay will end September 30, 2026.
Background: In response to the COVID-19 public health emergency and the guidance provided by CMS, the Texas HHSC is making Non-Risk payments (NRP) to reimburse MCOs or TCHP for COVID-19 related services.
