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Update to TMPPM Outpatient Drug Services Handbook for Blood Factor Products

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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 February 1, 2021, TMHP will update the Texas Medicaid Provider Procedures Manual, Outpatient Drug Services Handbook to remove subsection 7.10, “Blood Factor Products.”

The procedure codes in this section do not have prior authorization criteria.

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