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Medicaid Preferred Drug List and Formulary Changes Cambios 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 Resources Actualización 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 Update Actualización 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.

Learn more

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.

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Update to RSV Vaccine Age Restrictions

Date: October 14, 2025

Attention: Providers

Effective date: June 25, 2025

Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective June 25, 2025 the age range limitations for the respiratory syncytial virus (RSV) vaccine (procedure codes 90679 and 90683) have been updated to include coverage for Texas Medicaid members 50 years of age or older. The administration code 90471 should accompany these vaccine codes.

How this impacts providers: The update to the age range limitation will be outlined in the November 2025 edition of the Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, in section 9.2.35.1, “Administration Fee,” and section 9.2.39, “Respiratory Syncytial Virus (RSV).”

Claims information:

  • MCOs like TCHP must reprocess affected claims submitted with these procedure codes and date of service on or after June 25, 2025.
  • Providers are not required to appeal the claims unless they are denied for additional reasons after the claims reprocessing is complete.
  • Providers may bill MCOs like TCHP retroactively for procedure code 90679 and 90683 for members 50 years of age or older.

Next step for Providers: Providers should share this information with their staff.

If you have any questions, please email Provider Relations at providerrelations@texaschildrens.org

For access to all provider alerts: www.texaschildrenshealthplan.org/provideralerts.