Mental Health and Substance Use Services for Adult Members
Authorization Requirement Updates- Pharmacy DME Orthosis Urology_10.09.25
Authorization Requirement Updates Pharmacy Radiology DME_10.09.25
Authorization Requirement Update_PDN UA Modifier Requirement_Effective 11.01.2025_10.01.25
Authorization Requirement Updates - Cardiovascular Service - Gastroenterology Service_09.19.25
Authorization Requirement Updates Clinician Administered Drugs_09.17.25
Authorization Requirement Update Clinician Administered Drugs_Effective 11.1.25_09.17.25
Attention Texas Flood Allowances for Appeals and Authorizations_08.25.25
Procedure Codes Which Do Not Require Prior Auth_08.21.2025
Attention Taxonomy Requirements for Applied Behavior Analysis (ABA) Providers _8.21.25
Medical Necessity Guidelines_08.06.2025
Attention - Rider 32 Provider Notification 07.18.25
Authorization Requirement Updates Clinician Administered Drugs_7.18.25
Authorization Requirement Updates Clinician Administered Drugs DME_7.18.25
Authorization Requirment Update - DME.Hematology 07.10.25
Authorization Requirement Update -DME.Pharmacy 07.10.25
Authorization Requirement Update - PT Treatment Status Post Select Orthopedic Procedures_06.26.2025
Authorization Requirement Update - PT Treatment Status Post Select Orthopedic Procedures_06.24.2025
Authorization Requirement Update - Updates_No Auth Required Procedure Codes_06.18.2025
Important Compliance Reminder (Incontinence Supply Quantities)_06.13.2025
Authorization Requirement Update - Trevimbra_06.13.2025
Authorization Requirement Update - Dual-Function Home Ventilator_06.13.2025
Authorization Requirement Update - Incontinence Supply Requests_06.04.2025
High-Cost Clinician Administered Drugs (HCCAD)_5.13.2025
Authorization Requirement Updates - Pharmacy_Rad Therapy_Podiatry Services_5.12.2025
Authorization Requirement Updates -Pharmacy_Wound Care_Gen Surgery Services_5.12.2025
New Availity Quick Claims Portal Now Availaible to DHP Providers_4.29.25
PEMS to Be Updated to Allow Provider Credentialing 4.17.25
Authorization Requirement Updates - Pharmacy_Pneumococcal Vaccine_3.24.2025
Authorization Requirement Updates - Therapy Services_3.24.2025
Authorization Requirement Updates - CFP Services_3.13.2025
Authorization Requirement Updates - Behavioral Health and DME Services_3.13.2025
Authorization Requirement Updates - Pharmacy_DME_and Other Services_3.12.2025
Authorization Requirement Updates - Pharmacy Services - Procedure Code J0889_1.08.2025
Authorization Requirement Updates - Pharmacy, DME, and Home Infusion Services_10.23.2024
Authorization Requirement Updates - COVID-19 Vaccines_10.23.2024
Authorization Requirement Updates - Pharmacy and Allergy Services_10.09.2024
In Lieu of Services Provider Education_10.01.2024
Authorization Requirement Updates for Behavioral Health Services_In Lieu of Services_10.01.2024
Authorization Requirement Update - Therapy Re-evaluations_10.01.2024
Authorization Requirement Updates_Wound Care Services_10.01.2024
Authorization-Requirement-Updates-Pharmacy-Services 09.16.2024
Attention Provider Portal Update - New Referral Type 09.05.2024
Auth Req Updates - Neurotransmitter_Prev Med_and Dental Anes Services_2nd Notice 08.30.2024
Authorization Requirement Updates - General Surgery_Orthopedic_and Pharmacy Services 08.27.2024
Authorization Requirement Updates - GI and Resp. PCR Testing 08.06.2024
Authorization Requirement- Rural or Federal Heath Center, Pharmacy Services 07.18.2024
DHP Provider Portal and HEDIS 07.02.24Authorization Requirement Updates-06.28.24
Co-pays for CHIP COVID-19 services-06.28.24
TMPPM Update of Elevated Blood Lead Level-06.28.24
Hepatitis C Information Letter-6.14.24
Authorization Requirements-Pharmacy Services-4.11.24
Post-Partum Eligibility and Billing TMHP for Claims-3.28.24
Authorization Requirement Updates - Cardiology Services-3.27.24
EDI Claims Transactions Now Available through Availity-3.22.24
EDI Claims Transactions Now Available through Availity-3.13.24
EDI Claims Transactions Now Available through Availity-3.8.24
Change Healthcare/Optum Update-3.6.24
Change Healthcare/Optum Update-3.1.24
Change Healthcare/Optum Update-2.27.24
Change Healthcare/Optum Update-2.23.24
Change Healthcare/Optum Update-2.22.24
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The vendor drug program manages the state Medicaid and CHIP formularies. The website is a great resource to determine if a medication is formulary or to determine which MCOs have implemented a prior authorization.
Texas Health & Human Services News Texas Health Steps Provider InformationPlease contact our representatives for support with member eligibility, benefits, prior authorizations, claims or other provider services.
