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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 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.