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Growth Hormone Injection Benefits to Change for the CSHCN Services Program on February 1, 2021

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Effective for dates of service on or after February 1, 2021, growth hormone injection benefits will change for the Children with Special Health Care Needs (CSHCN) Services Program.

Noonan syndrome and SHOX deficiency will be added as covered conditions for growth hormone injections.

Refer to: The CSHCN Services Program Provider Manual, subsection 31.2.25.13.1, “Prior Authorization Requirements,” for prior authorization criteria.

Requests for clients with Noonan syndrome or SHOX deficiency may be approved without evidence of deficient growth hormone production on provocative testing if other criteria are met.

Clients with a diagnosis of panhypopituitarism whose epiphyses have closed will be considered for approval with documentation of deficient growth hormone levels.

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