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Update to Age and Diagnosis Restrictions for Injection Drugs for the CSHCN Services Program

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Effective for dates of service on or after March 1, 2022, age and diagnosis restrictions have been updated for the injection drug procedure codes listed below:

  • Procedure code J0596 is restricted to clients who are 13 years of age or older.
  • Procedure code J0598 and procedure code J0599 are restricted to clients who are 6 years of age or older.
  • Procedure codes J0596 and J0599 are restricted to diagnosis code D841.
  • Procedure code J9348 is no longer restricted by diagnosis.

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