Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.
Effective for dates of service on or after September 1, 2018, benefit language for Hydroxyprogesterone caproate procedure codes J1726 and J1729 will be updated in the Obstetric Services policy for Texas Medicaid.
Hydroxyprogesterone caproate is administered once weekly (every 7 days) by injection.
For more information, call the TMHP Contact Center at 800-925-9126.