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 April 1, 2021, ferric derisomaltose (procedure code J1437) is a benefit of Texas Medicaid.
Ferric derisomaltose (procedure code J1437) may be indicated for, but is not limited to, treatment of iron deficiency anemia for adult clients with:
- Intolerance or unsatisfactory response to oral iron.
- Non-dialysis-dependent chronic kidney disease.
For more information, call the TMHP Contact Center at 800-925-9126.