Sleep Study Prior Authorization Update

Date: August 19, 2021 Attention: Primary Care Providers , Neurologists Effective Date: December 1, 2021Providers 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: Effective December 1, 2021, Texas Children’s Health Plan will require a prior authorization for sleep studies for Members ages over 18 years old. This applies to the following CPT Codes: 95805, 95810, and 95811. How this impacts providers: When applicable, providers should utilize this Standard Prior Authorization Form and request an authorization. Medical Services Fax Line - 832-825-8760 or Toll-Free 1-844-473-6860 Next steps for providers: Providers should share this prior authorization update with their staff. If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.