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Antivenin Procedure Code J0841 (ANAVIP®) to Become a Medicaid Benefit

Date: July 5, 2022Attention: All ProvidersEffective Date: June 1, 2022Providers 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 inform providers that Health and Human Services Commission (HHSC) has identified an alternative antivenom, Antivenin (ANAVIP) that is used to treat the same snake bites as CROFAB which was previously covered, but is now not a benefit. How this impacts providers: Beginning June 1, 2022 Antivenin (ANAVIP) will become a Medicaid Benefit. ANAVIP® is an antivenom indicated for the management of adult and pediatric patients with North American Pit Viper envenomation. It received initial U.S. Food and Drug Administration (FDA) approval in 2015 and coverage was extended for three additional North American snake species in 2021. Effective for dates of service on or after June 1, 2022, antivenin procedure code J0841 (ANAVIP®) will become a benefit of Texas Medicaid. Procedure code J0841 may be reimbursed for the following places of service and provider types:
Place of ServiceProvider Type
OfficePhysician assistants, nurse practitioners, clinical nurse specialists, and physicians
Outpatient hospitalHospital providers
Next steps for providers: Prescribers should share this communication 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