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Updated CSHCN Prior Authorization Request for Medical Nutritional Products Form and Instructions Effective November 1, 2021

Last updated on 10/22/2021

Effective for dates of service on or after November 1, 2021, providers must use the updated CSHCN Services Program Prior Authorization Request for Medical Nutritional Products Form and Instructions.

Nutritional counseling services must now be requested using the CSHCN Services Program Request for Authorization and Prior Authorization Request Form and Instructions.

Requests Submitted Through the Prior Authorization Portal

The following updates will be made for requests submitted through the prior authorization portal:

  • The submenu for Medical Food will be removed.
  • Medical Nutritional Products will be added as a requested service.
  • The CSHCN Services Program Prior Authorization Request for Medical Nutritional Products Form will be added to the Upload Attachments Tab.

Providers may refer to the article titled “Benefit Updates for CSHCN Medical Nutritional Products Effective November 1, 2021” for benefit information.

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