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Update to Physician Chapter in the CSHCN Services Program Provider Manual

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On January 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update the Children with Special Health Care Needs (CSHCN) Services Program Provider Manual, Chapter 31: Physician, subsection 31.2.26.5, “Injection Procedure Codes.”

The following updates will be made:

  • Diagnosis code G360 will be added as a payable diagnosis for ravulizumab-cwvz (Ultomiris) (procedure code J1303).
  • Diagnosis code C9200 will be added as a payable diagnosis for azacitidine (Vidaza) (procedure code J9025).

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