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Parsabiv Drug to be Included in Method I Composite Rate for Renal Dialysis Facilities

Last updated on 11/15/2019

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.

Beginning December 1, 2019, TMHP will update the Texas Medicaid Provider Procedures Manual, Clinics and Other Outpatient Facility Services Handbook, subsection 6.2.2, “Renal Dialysis Facilities-Method I Composite Rate.” The list of drugs included in the Method I composite rate for renal dialysis facilities will be updated to include Parsabiv (etelcalcetide) procedure code J0606.

For more information, call the TMHP Contact Center at 800-925-9126.