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Update to TMPPM Outpatient Drug Services Handbook for Colony Stimulating Factors

Last updated on 7/28/2023

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

On August 1, 2023, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual (TMPPM), Outpatient Drug Services Handbook, section 6.25 “Colony Stimulating Factors (filgrastim, pegfilgrastim, and argramostim)” to add pegfilgrastim-fpgk (Stimufend) procedure code Q5127.

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