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 July 1, 2020, Esketamine (Spravato) may be distributed through specialty pharmacy providers enrolled in the Spravato Risk and Evaluation Mitigation Strategy (REMS) program to provide services to clients who are 18 years of age or older.
For more information, call the TMHP Contact Center at 800-925-9126.