Benefit Changes Prior Authorization Update

Attention: All Texas Children’s Health Plan ProvidersSubject: UPDATE to Changes for Physical, Occupational, and Speech Therapy Benefits Prior Authorization Changes Update Changes to TCHP Prior Authorizations for PT, OT, and ST services:

For therapy authorizations with approved dates of service spanning the 9/1 transition date, TCHP created a revised authorization in our system that reflects the new billing structure using the same authorization number.
For all therapy requests that were submitted prior to 9/1, the revised authorization will start on 9/1 and cover through the end of the authorized period. Providers will not need to change their authorization reference number for claims submission.
Providers should bill according to correct billing structure for the date of service. There is no further action required from providers.
TCHP will continue to prefer the Texas Standard Prior Authorization form available on our website for Therapy requests.

https://www.texaschildrenshealthplan.org/sites/default/files/pdf/Prior%20Authorization%20Requirements_JUNE%202018.pdf Please utilize the Utilization Management Authorization fax line for the following services:

Medical Services 832-825-8760 or Toll Free 844-473-6860
Behavioral Health Services 832-825-8767 or Toll Free 844-291-7505