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
Attention: Behavioral Health Providers and inpatient facilities
Attention: Behavioral Health Providers and inpatient facilitiesProviders should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event. TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.Call to action: Texas Children’s Health Plan (TCHP) would like to remind network providers that we require all members receiving inpatient psychiatric services to be scheduled prior to discharge for outpatient follow-up and/or continuing treatment with a network behavioral health provider.
The timeframe requirements are as follows:
- Initial outpatient treatment after discharge must occur within seven (7) days from the date of discharge. The appointment should not occur on day of discharge.
- The second appointment after discharge must occur within thirty (30) days from the date of discharge.
- The appointment must be with a network psychiatrist, psychologist or therapist (LCSW, LPC, etc).
- Missed appointments must be rescheduled within twenty-four (24) hours.
- Due to appointment availability, it may be necessary to schedule the initial seven (7) day follow-up appointment with a therapist and continue treatment with the therapist until the psychiatric thirty (30) day follow-up appointment is met.
- Minimal panel requirement: five (5) compliant members per payment period (6 months).
- Population: Members age 6 and older who were hospitalized for treatment of selected Mental illness or intentional self-harm diagnoses between 1/1/2021-12/31/2021.
- Incentive: $100.00 once per member age 6 years and older who was hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health practitioner within 7 days of discharge during calendar year 2021.