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Clinical Prior Authorization for Acute Treatment of Calcitonin Gene-Related Peptide Receptor Antagonists in Texas Medicaid Schedule Begins January 10, 2023

Last updated on 12/5/2022

The Texas Health and Human Services Commission (HHSC) will implement clinical prior criteria for the acute treatment of calcitonin gene-related peptide (CGRP) receptor antagonists for clients of Texas Medicaid on January 10, 2023. CGRP antagonists treat acute migraine headaches.

This clinical prior authorization is optional for managed care organizations (MCOs). The Pharmacy Clinical Prior Authorization Assistance Chart shows each MCO's prior authorizations and how those authorizations relate to those used for processing fee-for-service Medicaid claims. This chart is updated quarterly. Providers can also refer to the MCO Resources for links to each MCO's list of clinical prior authorizations.

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