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Treatment Indications to Change for Ferric Carboxymaltose Effective July 1, 2022

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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, precertification, 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 July 1, 2022, treatment indications for ferric carboxymaltose (procedure code J1439) will change.

Beginning July 1, 2022, ferric carboxymaltose (procedure code J1439) may be indicated for but not limited to treatment of iron deficiency anemia for the following:

  • Adult and pediatric clients who are one year of age or older with intolerance or unsatisfactory response to oral iron
  • Adult clients with non-dialysis-dependent chronic kidney disease

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