Medical Necessity Guidelines

Augmentative Communicative Devices

Back pain

Backup Mechanical Ventilator

Behavioral Health and Substance Use Disorder Non-Covered Benefit Process

Bell's Palsy Physical Therapy

Bilateral Tubal Ligation with Salpingectomy or Oophorectomy

Bunionectomy

Carpal Tunnel Syndrome

Cranial Molding Orthoses

Cystic Fibrosis

Flat feet and Orthotics

Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing

Genetic Testing for Suspected Disability

Incontinence Supplies

Lingular Frenulectomy

Lumbago of Pregnancy

Mobile X-Ray

Nutritional Supplements

Osgood-Schlatter Disease

Patellofemoral Pain Syndrome

Polymerase-Chain-Reaction-Respiratory-Viral-Panel-Testing

PDN SNV PPECC Medical Necessity Guideline

Pediatric Sleep Study & Home Sleep Study

Personal Care Services

Specialty Hospital Beds

TMPPM Children Services Handbook Volume 2, Section 2.3, Medicaid Autism Services Policy

Therapy Telehealth

Umbilical Hernia Repair

Using Large Genetic Testing Panels

Resources

DHP Utilization Management

1-877-455-1053

1-866-741-5650

DHP STAR Kids LTSS Services

1-844-376-5437

1-844-381-5437

Monday – Friday
8:00 a.m. – 5:00 p.m. (CST) Excluding state holidays.
Messages will be returned within one business day.

Monday - Friday

8:00 a.m. — 5:00 p.m. (CST)

Excluding state holidays. Interpretive services available upon request.

Program Help Line:

1-800-964-2777

Deaf & Hard of Hearing:

1-800-735-2989

Nurse Advice Line:

STAR Kids Nueces:
1-844-308-8701
STAR Kids Hidalgo:
1-844-714-7887

Member Services

1-877-324-7543

Medical Necessity Guidelines

Resources

Contact Information

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News & Helpful Links

News And Updates