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Update to TMPPM Outpatient Drug Services Handbook

Date: February 7, 2025

Attention: All Providers

Effective date: January 1, 2025

Call to action: The purpose of this communication is to inform providers that on January 1, 2025, Texas Medicaid & Healthcare Partnership (TMHP) updated the Texas Medicaid Provider Procedures Manual (TMPPM), Outpatient Drug Services Handbook, section 6.104, “Ravulizumab-cwvz (Ultomiris)” and section 6.14, “Azacitidine (Vidaza).”

The following updates were made:

  • Diagnosis code G360 will be added as a payable diagnosis for ravulizumab-cwvz (Ultomiris) (procedure code J1303).
  • Diagnosis code C9200 will be added as a payable diagnosis for azacitidine (Vidaza) (procedure code J9025).

Next steps: Providers should 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.