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16.3.2 Prior Authorization
The CRCP must request and receive prior authorization from TMHP for in-home respiratory therapy services. Prior authorization requests must include the dated physician's order, all pertinent medical records, and other information to justify the medical necessity/dependency of ventilator support and/or requested therapy services. Authorization may be given for up to 12 months and may be extended based on an interim report from the physician that documents the medical necessity and appropriateness of continued in-home respiratory therapy services.
All supporting documentation must be included with the request for authorization. Providers should send requests and documentation to the following address:
Texas Medicaid & Healthcare Partnership
Special Medical Prior Authorization
12357-A Riata Trace Parkway, Suite 150
Austin, TX 78727
Fax: 1-512-514-4213
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