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Updated Home Telemonitoring Services Prior Authorization Request Form to Include FQHC and RHC Effective September 1, 2024

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

Effective September 1, 2024, the Home Telemonitoring Services Prior Authorization Request Form has been updated to include federally qualified health center (FQHC) and rural health clinic (RHC) providers.

The Texas Medicaid & Healthcare Partnership (TMHP) will continue to accept the previous version of the home telemonitoring prior authorization request form for 90 days after September 1, 2024. After this transition period ends, only the updated form will be accepted.

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