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Benralizumab, Mepolizumab, and Omalizumab Benefits in the Home Setting for the CSHCN Services Program

Last updated on 6/5/2020

Effective for dates of service on or after July 1, 2020, benralizumab, mepolizumab, and omalizumab may be provided in the home setting for the Children with Special Health Care Needs (CSHCN) Services Program.

Procedure codes J0517, J2182, and J2357 will be a benefit in the home setting when services are provided by medical supplier (durable medical equipment) providers.

Providers may refer to the current Children with Special Health Care Needs (CSHCN) Services Program Provider Manual, Physician Chapter, section 31.2.25.16, “Monoclonal Antibodies-Asthma and Chronic Idiopathic Urticaria,” for additional benefit information.

For more information, call the TMHP-CSHCN Services Program Contact Center at 800-568-2413.