Provider Notices

Provider Notices

STAR/CHIP
STAR+PLUS
Medicare
Health Insurance Marketplace

2024 Notices

Reminder: Early and Periodic Screening, Diagnosis, and Treatment Coverage Requirements (posted 11/13/2024)
Updated Prior Authorization Catalogs for STAR, CHIP and STAR+PLUS (effective 11/01/2024)
Oct. 2024 JW Modifier Eligible Drugs List Available (posted 11/05/2024)
Revisions to the Uniform Opioid Policy; Changes Required by March 1, 2025 (posted 10/28/2024)
Oct. 2024 Specialty Drug List Now Available (posted 10/28/2024)
HHSC Will No Longer Cover Oxbryta Products As Of Oct. 17, 2024 (posted 10/28/2024)
PPECC Benefit Criteria Updates for Texas Medicaid Effective December 1, 2024 (posted 10/28/2024)
Prior Authorization Criteria for Imdelltra Effective Nov. 1, 2024 (posted 10/28/2024)
Prior Authorization Criteria for Anktiva Effective Nov. 1, 2024 (posted 10/28/2024)
Updated Prior Authorization Catalogs for STAR, CHIP and Marketplace (effective 10/15/2024)
SFY 2025 Appointment Availability Vision Provider Study – Provider Directory Request Due Oct. 17 (posted 10/9/2024)
HHSC to Remove Oxbryta Products from all Formularies as of Oct. 10, 2024 (posted 10/9/2024)
Enfamil Gentlease, Enfamil A.R and Enfamil Reguline Possible Shortages (posted 10/9/2024)
Coverage of the HPV Vaccine and ASN Updates (posted 10/9/2024)
Change in Preferred Drug List Status for Generic Sildenafil Oral Suspension Takes Effect Sept. 25 (posted 10/2/2024)
2024–25 RSV Season and Synagis Prior Authorization for All State Health Service Regions (posted 10/2/2024)
Adult Foster Care Residential Agreement Checklist (posted 10/2/2024)
Some COVID-19 Vaccine Procedure Codes No Longer a Benefit of Texas Medicaid & CHIP (Effective 10/01/2024)
2024-2025 COVID-19 Vaccines Added to Pharmacy Benefit (effective Sept. 10, 2024)
Change in Preferred Drug List Status for Glucocorticoids, Inhaled Drug Class Takes Effect August 22 (posted 10/2/2024)
SFY 2025 Appointment Availability Prenatal Provider Study – Provider Directory Request Due Sept. 22 (posted 9/27/2024)
Reminder- Non-Payable Codes Prior Authorization Process (effective 10/1/2024)
Reminder: VDP Changed PDL Status for “Glucocorticoids, Inhaled” Drug Class Effective Dec. 15, 2023 (posted 9/24/2024)
Guidance and Deadlines for Phase 2 of Identifying Maternal Mental Health Providers (posted 9/24/2024)
HHSC to Begin Surveying Adult Foster Care (AFC) Home Providers For SFY 2023 (effective 09/03/2024)
Updated Texas Administrative Code (TAC) References in CDS Forms (Effective 09/01/2024)
VDP Changes For COVID-19 Post-Public Health Emergency (posted September 10, 2024)
CMS Approval Pending for CHIRP Payments (posted September 5, 2024)
Medicaid-Only Claims for Dual Eligible Enrollees Will Forward to MCOs (posted September 3, 2024)
Skilled Nursing Facility Coinsurance (posted September 3, 2024)
Effective Immediately – Community is Changing Paper Claims Address for All Lines of Business (posted August 27, 2024)
Home Telemonitoring Services Adding Federally Qualified Health Centers and Rural Health Clinics as Providers (effective September 1, 2024)
Co-pays for CHIP COVID-19 services will resume starting October 1, 2024 (posted August, 19, 2024)
Proof of Delivery for Durable Medical Equipment (DME), Supplies, and Nutritional Products (posted August, 19, 2024)
CHIP MCOs: Reinstatement of CHIP Co-pays for COVID-19 Vaccines, Treatment, and Testing Services (effective October 1, 2024)
HB 1575 New Provider Type Codes for Community Health Workers and Doulas (posted August 19, 2024)
COVID-19 Vaccine and Vaccine Administration Medicaid and CHIP Updates (effective October 1, 2024)
Influenza Vaccine Procedure Code 90653 to Become a Benefit of Texas Medicaid (effective Sept. 1, 2024)
Prescribed Pediatric Extended Care Center (PPECC) Updates (effective September 1, 2024)
Multi-Factor Authentication implementation in August 2024 (posted August 12, 2024)
Guidance on Member Allegations of Provider Discrimination Based on Immunization Status (posted August 12, 2024)
Collaborative Care Model Attestation Process to Update on August 1, 2024 (posted July 24, 2024)
New Provider Type and Specialty for Rural Emergency Hospitals (effective June 3, 2024)
Update and Revision to National Drug Codes (NDCs) Added to Medicaid, CHIP Formularies (posted July 24, 2024)
Enfamil Reguline 12.4 oz Powder Limited Availability in Retail Stores Until Mid-July 2024 (posted July 12, 2024)
Texas Medicaid HepCure (posted June 7, 2024)
Community requirement of TMPPM Criteria for review of speech therapy services (posted May 31, 2024)
Maximum Allowable Amount For Non-Risk Based Drugs Billed With ‘Unclassified’ Procedure Codes (posted May 29, 2024)
Change in Preferred Drug List Status for Antihyperuricemics Drug Class (effective April 22, 2024)
Claims Editing Program Notification (effective on August 1, 2024)
Medical Benefit Prior Authorization Updates (posted April 19, 2024)
Provider Notification: Claims Routing Process Update (posted April 12, 2024)
Newly Required PDMP Data Information for CMS Annual Drug Utilization Review Survey for Federal Fiscal Year 2024 (posted April 30,2024)
Community Health Choice is Excited to Announce Our Upcoming Move!
Provider Notification: Claims Routing Process Update (effective February 28, 2024)
Updates to Vaccine Administration Procedure Code M0201
(effective February 05, 2024)
HB 916 Contraceptive Coverage – 12 Month Supply
(effective September 1, 2023)
Provider Type and Places of Service Update for Procedure Code 96372 Effective Jan. 1
(posted 1/16/24)

2023 Notices

HB 916 Contraceptive Coverage – 12 Month Supply (Effective September 1,2023)
RSV Vaccine Procedure Code 90678 is Now a Benefit for Pregnant Individuals (Effective Oct. 1, 2023)
Telemedicine and Telehealth Benefit Updates For RHC’s and FQHC’s (Effective Nov. 1, 2023)
New Texas Medicaid & Healthcare Partnership (TMHP) Contracts (posted 10/10/23)
Process for Provider Disputes Regarding Professional Competence or Conduct Revised – Effective November 7, 2023 (posted 10/05/23)
Prior Authorization Requirements – Effective January 1, 2024 (posted 10/02/23)
Prior Authorizations – Process Extended to October 8, 2023 – Important Update (posted 9/22/23)
Prior Authorizations – Process Extended to September 22, 2023 – Important Update (posted 9/11/23)
Prior Authorizations – Process Extended to September 8, 2023 – Important Update (posted 9/01/23)
Prior Authorizations – Process Extended to September 1, 2023 – Important Update (posted 8/18/23)
Effective July 1, 2023, Facilities Enrolled in Texas Medicaid Should Submit the Texas Facility Credentialing Application Directly to Verisys (posted 8/15/23)
Prior Authorizations – Process Extended to August 18, 2023 – Important Update (posted 8/04/23)
Prior Authorizations – Process Extended to August 4, 2023 – Important Update (posted 7/31/23)
Register for Initial EVV Policy Training Webinar for Program Providers and FMSAs – July 27, 2023 (posted 7/18/23)
Prior Authorizations – Important Update (posted 7/7/23)
PHE Unwinding FAQs (posted 6/6/23)
End of PHE CMCS Information Bulletin (posted 6/6/23)
FAQs for CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency (posted 6/6/23)
Nursing Home Visitation – COVID-19 – Revised (posted 6/6/23)
CLIA Surveyor Guidance for New and Modified CLIA Requirements Related to COVID-19 (posted 6/6/23)
CHC Provider Notification Letter Progeny Health Effective August 23, 2023 (posted 5/31/23)
Invalid NPI in NPPES to Trigger Disenrollment Action (posted 4/28/23)
Prior Authorization Requests: Supporting Clinical Documentation Required for Transplants – Effective May 10, 2023 (posted 4/10/23)
Update to COVID-19 Accommodations for the Member State Fair Hearing Process (posted 3/31/23)
Co-Pays For Some CHIP Services Will Resume Starting May 12, 2023 (posted 3/17/23)
Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers – Ending on May 11, 2023 (posted 3/07/23)
Medicaid Applied Behavior Analysis (ABA) Services for Children and Youth With Autism (posted 2/27/23)
Signature Requirement for Medicaid Home Health Services Effective April 22, 2023 (posted 2/24/23)
Update to Community’s Paper Claim Submission PO Box Address Change (posted 1/23/23)
Diabetic Equipment and Supplies Benefits to Change for Texas Medicaid January 1, 2023 (posted 1/20/23)

2022 Notices

Hepatitis C Treatment Coverage and PDL Update Scheduled for January 1, 2023 (posted 12/12/22)
EVV Cures Act Home Health Care Services Implementation Confirmed for Jan. 1, 2024 (posted 11/3/22)
Community’s Paper Claim Submission PO Box Address Changes Coming in 2023 (posted 10/26/22)
Potential Electronic Visit Verification Changes Coming in 2023 – Scheduled to expire on Aug. 31, 2023 (posted 10/18/22)
Case Management for Children and Pregnant Women – Changes Effective September 1, 2022 (posted 8/25/22)
CHIP Vaccine Updates Effective September 1, 2022 (posted 8/17/22)
Hepatitis C Treatment Coverage and PDL Update Scheduled for September 1, 2022 (posted 8/15/22)
Provider Enrollment Effective Dates (posted 8/9/22)
Quality Articles: Teen Nutrition and Annual Physical, Post-Partum Care For High Risk Mothers, Anxiety & Depression Screening, and Teen Vaccinations (posted 7/11/22)
Update to HB4: Behavioral Health Services Delivered by Synchronous Audio-visual or Telephone (Audio-only) Interim Guidance (posted 6/29/22)
Client Access to Mosquito Repellent Benefit Beginning June 1, 2022 (posted 5/27/22)
Clinical Laboratory Improvement Amendments (posted 5/9/22)
HHSC To Request Extension Of EVV Cures Act Home Health Care Services Implementation to January 1, 2024 (posted 5/4/22)
CHIP Copayments for MH and SUD Outpatient Office Visits & Residential Services Prohibited Effective July 1, 2022 (posted 4/8/22)
Medicaid ABA Services Effective February 1, 2022 – Updated (posted 7/25/22)

2021 Notices

Prior Authorization Requirements Effective January 1, 2022 (posted 10/1/21)
Hurricane Ida Information for Medicaid Providers (posted 9/2/21)
Implementation Deadline of Provider Recoupment Policy (posted 8/20/21)
Home Health Care Services Required to Use EVV by Jan. 1, 2023 (posted 8/5/21)
Texas State of Emergency Declaration(posted 5/21/21)
Non-Emergency Medical Transportation for STAR Members (posted 5/12/21)
Healthy Texas Women Needs New Providers (posted 1/14/21)

2020 Notices

2021 Notice to Physicians and Providers on Accepting Applications (posted 12/18/20)
Claims Processing Updates & Reminders (posted 11/4/20)
Medical Review Guidelines Effective 2/1/21 (posted 11/1/20)
Automated Prior Authorization Process (posted 10/5/20)
Claimsxten Update (posted 10/1/20)

2024 Notices

Updated Prior Authorization Catalogs for STAR, CHIP and STAR+PLUS (effective 11/01/2024)
Additional 2023 CPC Cost Report Training Information for LTSS STAR+PLUS Providers (posted 10/9/2024)
Reminder- Non-Payable Codes Prior Authorization Process (effective 10/1/2024)
Updated Texas Administrative Code (TAC) References in CDS Forms (posted 9/4/2024)
Skilled Nursing Facility Coinsurance (posted 9/3/2024)
Continuity of Care During the STAR+PLUS Transition (posted 8/28/2024)
Effective Immediately – Community is Changing Paper Claims Address for All Lines of Business (posted 8/27/ 2024)
Attendant Compensation Rate Enhancement Program Request for Participation Attestation

2024 Notices

Prior Authorization Updates for Marketplace and DSNP (effective January 01, 2025)
Updated Prior Authorization Catalogs for Marketplace and DSNP (effective January 01, 2025)
Skilled Nursing Facility Coinsurance (posted September 3, 2024)
Effective Immediately – Community is Changing Paper Claims Address for All Lines of Business (posted August 27, 2024)
Multi-Factor Authentication implementation in August 2024 (posted August 12, 2024)
Claims Editing Program Notification (Effective on August 1, 2024)
Reminder: LPC and LMFT Providers Must Enroll in Medicare Effective March 1, 2024 (posted April 15, 2024)
Provider Notification: Claims Routing Process Update (posted April 12, 2024)
Community Health Choice is Excited to Announce Our Upcoming Move!
Provider Notification: Claims Routing Process Update (Effective February 28, 2024)

2023 Notices

Prior Authorizations – Process Extended to October 8, 2023 – Important Update (posted 9/22/23)
Prior Authorizations – Process Extended to September 22, 2023 – Important Update (posted 9/11/23)
Prior Authorizations – Process Extended to September 8, 2023 – Important Update (posted 9/01/23)
Prior Authorizations – Process Extended to September 1, 2023 – Important Update (posted 8/18/23)
Effective July 1, 2023, Facilities Enrolled in Texas Medicaid Should Submit the Texas Facility Credentialing Application Directly to Verisys (posted 8/15/23)
Prior Authorizations – Process Extended to August 18, 2023 – Important Update (posted 8/04/23)
Prior Authorizations – Process Extended to August 4, 2023 – Important Update (posted 7/31/23)
Prior Authorizations – Important Update (posted 7/7/23)
Prior Authorization Requests: Supporting Clinical Documentation Required for Transplants – Effective May 10, 2023 (posted 4/10/23)
Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers – Ending on May 11, 2023 (posted 3/07/23)
Update to Community’s Paper Claim Submission PO Box Address Change (posted 1/23/23)

2022 Notices

Community’s Paper Claim Submission PO Box Address Changes Coming in 2023 (posted 10/26/22)
Quality Articles: Teen Nutrition and Annual Physical, Post-Partum Care For High Risk Mothers, Anxiety & Depression Screening, and Teen Vaccinations (posted 7/11/22)
Clinical Laboratory Improvement Amendments (posted 5/9/22)

2021 Notices

Prior Authorization Requirements Effective January 1, 2022 (posted 10/1/21)
Implementation Deadline of Provider Recoupment Policy (posted 8/20/21)

2020 Notices

2021 Notice to Physicians and Providers on Accepting Applications (posted 12/18/20)
Claims Processing Updates & Reminders (posted 11/4/20)
Medical Review Guidelines Effective 2/1/21 (posted 11/1/20)
Automated Prior Authorization Process (posted 10/5/20)
Claimsxten Update (posted 10/1/20)

2024 Notices

Prior Authorization Updates for Marketplace and DSNP (effective January 01, 2025)
Updated Prior Authorization Catalogs for Marketplace and DSNP (effective January 01, 2025)
Updated Prior Authorization Catalogs for STAR, CHIP and Marketplace (effective October 15, 2024)
Effective Immediately – Community is Changing Paper Claims Address for All Lines of Business (posted August 27, 2024)
Multi-Factor Authentication implementation in August 2024 (posted August 12, 2024)
Claims Editing Program Notification (Effective on August 1, 2024)
Provider Notification: Claims Routing Process Update (posted April 12, 2024)
Community Health Choice is Excited to Announce Our Upcoming Move!
Provider Notification: Claims Routing Process Update (Effective February 28, 2024)

2023 Notices

Process for Provider Disputes Regarding Professional Competence or Conduct Revised – Effective November 7, 2023 (posted 10/05/23)
Prior Authorizations – Process Extended to October 8, 2023 – Important Update (posted 9/22/23)
Prior Authorizations – Process Extended to September 22, 2023 – Important Update (posted 9/11/23)
Prior Authorizations – Process Extended to September 8, 2023 – Important Update (posted 9/01/23)
Prior Authorizations – Process Extended to September 1, 2023 – Important Update (posted 8/18/23)
Effective July 1, 2023, Facilities Enrolled in Texas Medicaid Should Submit the Texas Facility Credentialing Application Directly to Verisys (posted 8/15/23)
Prior Authorizations – Process Extended to August 18, 2023 – Important Update (posted 8/04/23)
Prior Authorizations – Process Extended to August 4, 2023 – Important Update (posted 7/31/23)
Prior Authorizations – Important Update (posted 7/7/23)
Prior Authorization Requests: Supporting Clinical Documentation Required for Transplants – Effective May 10, 2023 (posted 4/10/23)
Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers – Ending on May 11, 2023 (posted 3/07/23)

2022 Notices

Marketplace FAQ 2023 (posted 12/27/22)
Community’s Paper Claim Submission PO Box Address Changes Coming in 2023 (posted 10/26/22)
Quality Articles: Teen Nutrition and Annual Physical, Post-Partum Care For High Risk Mothers, Anxiety & Depression Screening, and Teen Vaccinations (posted 7/11/22)
Clinical Laboratory Improvement Amendments (posted 5/9/22)

2021 Notices

House Bill 3459: Prior Authorization Transparency “Gold Carding” (posted 12/10/21).
Prior Authorization Requirements Effective January 1, 2022 (posted 10/1/21)
Texas State of Emergency Declaration (posted 5/21/21)

2020 Notices

2021 Notice to Physicians and Providers on Accepting Applications (posted 12/18/20)
Claims Processing Updates & Reminders (posted 11/4/20)
Medical Review Guidelines Effective 2/1/21 (posted 11/1/20)
Automated Prior Authorization Process (posted 10/5/20)
Claimsxten Update (posted 10/1/20)

National Provider Identifier

National Provider Identifier Information

Provider Participation

Become a Community Provider

Fraud, Waste or Abuse

Provider Advisory Group

TX Standard Credentialing App

Forms & Reference Guides

Health Insurance Marketplace

PCP Tool Kit

Alcohol and Substance Abuse Addiction

Bipolar Disorder

Eating Disorders

Major Depression

Important phone numbers

Health Insurance Marketplace

Provider Notices & Reminders

Health Insurance Marketplace

HHSC Notifications

Membership Rights & Responsibilities

Health Insurance Marketplace

STAR/CHIP

2024 Notices

Reminder: Early and Periodic Screening, Diagnosis, and Treatment Coverage Requirements (posted 11/13/2024)
Updated Prior Authorization Catalogs for STAR, CHIP and STAR+PLUS (effective 11/01/2024)
Oct. 2024 JW Modifier Eligible Drugs List Available (posted 11/05/2024)
Revisions to the Uniform Opioid Policy; Changes Required by March 1, 2025 (posted 10/28/2024)
Oct. 2024 Specialty Drug List Now Available (posted 10/28/2024)
HHSC Will No Longer Cover Oxbryta Products As Of Oct. 17, 2024 (posted 10/28/2024)
PPECC Benefit Criteria Updates for Texas Medicaid Effective December 1, 2024 (posted 10/28/2024)
Prior Authorization Criteria for Imdelltra Effective Nov. 1, 2024 (posted 10/28/2024)
Prior Authorization Criteria for Anktiva Effective Nov. 1, 2024 (posted 10/28/2024)
Updated Prior Authorization Catalogs for STAR, CHIP and Marketplace (effective 10/15/2024)
SFY 2025 Appointment Availability Vision Provider Study – Provider Directory Request Due Oct. 17 (posted 10/9/2024)
HHSC to Remove Oxbryta Products from all Formularies as of Oct. 10, 2024 (posted 10/9/2024)
Enfamil Gentlease, Enfamil A.R and Enfamil Reguline Possible Shortages (posted 10/9/2024)
Coverage of the HPV Vaccine and ASN Updates (posted 10/9/2024)
Change in Preferred Drug List Status for Generic Sildenafil Oral Suspension Takes Effect Sept. 25 (posted 10/2/2024)
2024–25 RSV Season and Synagis Prior Authorization for All State Health Service Regions (posted 10/2/2024)
Adult Foster Care Residential Agreement Checklist (posted 10/2/2024)
Some COVID-19 Vaccine Procedure Codes No Longer a Benefit of Texas Medicaid & CHIP (Effective 10/01/2024)
2024-2025 COVID-19 Vaccines Added to Pharmacy Benefit (effective Sept. 10, 2024)
Change in Preferred Drug List Status for Glucocorticoids, Inhaled Drug Class Takes Effect August 22 (posted 10/2/2024)
SFY 2025 Appointment Availability Prenatal Provider Study – Provider Directory Request Due Sept. 22 (posted 9/27/2024)
Reminder- Non-Payable Codes Prior Authorization Process (effective 10/1/2024)
Reminder: VDP Changed PDL Status for “Glucocorticoids, Inhaled” Drug Class Effective Dec. 15, 2023 (posted 9/24/2024)
Guidance and Deadlines for Phase 2 of Identifying Maternal Mental Health Providers (posted 9/24/2024)
HHSC to Begin Surveying Adult Foster Care (AFC) Home Providers For SFY 2023 (effective 09/03/2024)
Updated Texas Administrative Code (TAC) References in CDS Forms (Effective 09/01/2024)
VDP Changes For COVID-19 Post-Public Health Emergency (posted September 10, 2024)
CMS Approval Pending for CHIRP Payments (posted September 5, 2024)
Medicaid-Only Claims for Dual Eligible Enrollees Will Forward to MCOs (posted September 3, 2024)
Skilled Nursing Facility Coinsurance (posted September 3, 2024)
Effective Immediately – Community is Changing Paper Claims Address for All Lines of Business (posted August 27, 2024)
Home Telemonitoring Services Adding Federally Qualified Health Centers and Rural Health Clinics as Providers (effective September 1, 2024)
Co-pays for CHIP COVID-19 services will resume starting October 1, 2024 (posted August, 19, 2024)
Proof of Delivery for Durable Medical Equipment (DME), Supplies, and Nutritional Products (posted August, 19, 2024)
CHIP MCOs: Reinstatement of CHIP Co-pays for COVID-19 Vaccines, Treatment, and Testing Services (effective October 1, 2024)
HB 1575 New Provider Type Codes for Community Health Workers and Doulas (posted August 19, 2024)
COVID-19 Vaccine and Vaccine Administration Medicaid and CHIP Updates (effective October 1, 2024)
Influenza Vaccine Procedure Code 90653 to Become a Benefit of Texas Medicaid (effective Sept. 1, 2024)
Prescribed Pediatric Extended Care Center (PPECC) Updates (effective September 1, 2024)
Multi-Factor Authentication implementation in August 2024 (posted August 12, 2024)
Guidance on Member Allegations of Provider Discrimination Based on Immunization Status (posted August 12, 2024)
Collaborative Care Model Attestation Process to Update on August 1, 2024 (posted July 24, 2024)
New Provider Type and Specialty for Rural Emergency Hospitals (effective June 3, 2024)
Update and Revision to National Drug Codes (NDCs) Added to Medicaid, CHIP Formularies (posted July 24, 2024)
Enfamil Reguline 12.4 oz Powder Limited Availability in Retail Stores Until Mid-July 2024 (posted July 12, 2024)
Texas Medicaid HepCure (posted June 7, 2024)
Community requirement of TMPPM Criteria for review of speech therapy services (posted May 31, 2024)
Maximum Allowable Amount For Non-Risk Based Drugs Billed With ‘Unclassified’ Procedure Codes (posted May 29, 2024)
Change in Preferred Drug List Status for Antihyperuricemics Drug Class (effective April 22, 2024)
Claims Editing Program Notification (effective on August 1, 2024)
Medical Benefit Prior Authorization Updates (posted April 19, 2024)
Provider Notification: Claims Routing Process Update (posted April 12, 2024)
Newly Required PDMP Data Information for CMS Annual Drug Utilization Review Survey for Federal Fiscal Year 2024 (posted April 30,2024)
Community Health Choice is Excited to Announce Our Upcoming Move!
Provider Notification: Claims Routing Process Update (effective February 28, 2024)
Updates to Vaccine Administration Procedure Code M0201
(effective February 05, 2024)
HB 916 Contraceptive Coverage – 12 Month Supply
(effective September 1, 2023)
Provider Type and Places of Service Update for Procedure Code 96372 Effective Jan. 1
(posted 1/16/24)

2023 Notices

HB 916 Contraceptive Coverage – 12 Month Supply (Effective September 1,2023)
RSV Vaccine Procedure Code 90678 is Now a Benefit for Pregnant Individuals (Effective Oct. 1, 2023)
Telemedicine and Telehealth Benefit Updates For RHC’s and FQHC’s (Effective Nov. 1, 2023)
New Texas Medicaid & Healthcare Partnership (TMHP) Contracts (posted 10/10/23)
Process for Provider Disputes Regarding Professional Competence or Conduct Revised – Effective November 7, 2023 (posted 10/05/23)
Prior Authorization Requirements – Effective January 1, 2024 (posted 10/02/23)
Prior Authorizations – Process Extended to October 8, 2023 – Important Update (posted 9/22/23)
Prior Authorizations – Process Extended to September 22, 2023 – Important Update (posted 9/11/23)
Prior Authorizations – Process Extended to September 8, 2023 – Important Update (posted 9/01/23)
Prior Authorizations – Process Extended to September 1, 2023 – Important Update (posted 8/18/23)
Effective July 1, 2023, Facilities Enrolled in Texas Medicaid Should Submit the Texas Facility Credentialing Application Directly to Verisys (posted 8/15/23)
Prior Authorizations – Process Extended to August 18, 2023 – Important Update (posted 8/04/23)
Prior Authorizations – Process Extended to August 4, 2023 – Important Update (posted 7/31/23)
Register for Initial EVV Policy Training Webinar for Program Providers and FMSAs – July 27, 2023 (posted 7/18/23)
Prior Authorizations – Important Update (posted 7/7/23)
PHE Unwinding FAQs (posted 6/6/23)
End of PHE CMCS Information Bulletin (posted 6/6/23)
FAQs for CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency (posted 6/6/23)
Nursing Home Visitation – COVID-19 – Revised (posted 6/6/23)
CLIA Surveyor Guidance for New and Modified CLIA Requirements Related to COVID-19 (posted 6/6/23)
CHC Provider Notification Letter Progeny Health Effective August 23, 2023 (posted 5/31/23)
Invalid NPI in NPPES to Trigger Disenrollment Action (posted 4/28/23)
Prior Authorization Requests: Supporting Clinical Documentation Required for Transplants – Effective May 10, 2023 (posted 4/10/23)
Update to COVID-19 Accommodations for the Member State Fair Hearing Process (posted 3/31/23)
Co-Pays For Some CHIP Services Will Resume Starting May 12, 2023 (posted 3/17/23)
Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers – Ending on May 11, 2023 (posted 3/07/23)
Medicaid Applied Behavior Analysis (ABA) Services for Children and Youth With Autism (posted 2/27/23)
Signature Requirement for Medicaid Home Health Services Effective April 22, 2023 (posted 2/24/23)
Update to Community’s Paper Claim Submission PO Box Address Change (posted 1/23/23)
Diabetic Equipment and Supplies Benefits to Change for Texas Medicaid January 1, 2023 (posted 1/20/23)

2022 Notices

Hepatitis C Treatment Coverage and PDL Update Scheduled for January 1, 2023 (posted 12/12/22)
EVV Cures Act Home Health Care Services Implementation Confirmed for Jan. 1, 2024 (posted 11/3/22)
Community’s Paper Claim Submission PO Box Address Changes Coming in 2023 (posted 10/26/22)
Potential Electronic Visit Verification Changes Coming in 2023 – Scheduled to expire on Aug. 31, 2023 (posted 10/18/22)
Case Management for Children and Pregnant Women – Changes Effective September 1, 2022 (posted 8/25/22)
CHIP Vaccine Updates Effective September 1, 2022 (posted 8/17/22)
Hepatitis C Treatment Coverage and PDL Update Scheduled for September 1, 2022 (posted 8/15/22)
Provider Enrollment Effective Dates (posted 8/9/22)
Quality Articles: Teen Nutrition and Annual Physical, Post-Partum Care For High Risk Mothers, Anxiety & Depression Screening, and Teen Vaccinations (posted 7/11/22)
Update to HB4: Behavioral Health Services Delivered by Synchronous Audio-visual or Telephone (Audio-only) Interim Guidance (posted 6/29/22)
Client Access to Mosquito Repellent Benefit Beginning June 1, 2022 (posted 5/27/22)
Clinical Laboratory Improvement Amendments (posted 5/9/22)
HHSC To Request Extension Of EVV Cures Act Home Health Care Services Implementation to January 1, 2024 (posted 5/4/22)
CHIP Copayments for MH and SUD Outpatient Office Visits & Residential Services Prohibited Effective July 1, 2022 (posted 4/8/22)
Medicaid ABA Services Effective February 1, 2022 – Updated (posted 7/25/22)

2021 Notices

Prior Authorization Requirements Effective January 1, 2022 (posted 10/1/21)
Hurricane Ida Information for Medicaid Providers (posted 9/2/21)
Implementation Deadline of Provider Recoupment Policy (posted 8/20/21)
Home Health Care Services Required to Use EVV by Jan. 1, 2023 (posted 8/5/21)
Texas State of Emergency Declaration(posted 5/21/21)
Non-Emergency Medical Transportation for STAR Members (posted 5/12/21)
Healthy Texas Women Needs New Providers (posted 1/14/21)

2020 Notices

2021 Notice to Physicians and Providers on Accepting Applications (posted 12/18/20)
Claims Processing Updates & Reminders (posted 11/4/20)
Medical Review Guidelines Effective 2/1/21 (posted 11/1/20)
Automated Prior Authorization Process (posted 10/5/20)
Claimsxten Update (posted 10/1/20)

STAR+PLUS

2024 Notices

Updated Prior Authorization Catalogs for STAR, CHIP and STAR+PLUS (effective 11/01/2024)
Additional 2023 CPC Cost Report Training Information for LTSS STAR+PLUS Providers (posted 10/9/2024)
Reminder- Non-Payable Codes Prior Authorization Process (effective 10/1/2024)
Updated Texas Administrative Code (TAC) References in CDS Forms (posted 9/4/2024)
Skilled Nursing Facility Coinsurance (posted 9/3/2024)
Continuity of Care During the STAR+PLUS Transition (posted 8/28/2024)
Effective Immediately – Community is Changing Paper Claims Address for All Lines of Business (posted 8/27/ 2024)
Attendant Compensation Rate Enhancement Program Request for Participation Attestation

Marketplace

2024 Notices

Prior Authorization Updates for Marketplace and DSNP (effective January 01, 2025)
Updated Prior Authorization Catalogs for Marketplace and DSNP (effective January 01, 2025)
Updated Prior Authorization Catalogs for STAR, CHIP and Marketplace (effective October 15, 2024)
Effective Immediately – Community is Changing Paper Claims Address for All Lines of Business (posted August 27, 2024)
Multi-Factor Authentication implementation in August 2024 (posted August 12, 2024)
Claims Editing Program Notification (Effective on August 1, 2024)
Provider Notification: Claims Routing Process Update (posted April 12, 2024)
Community Health Choice is Excited to Announce Our Upcoming Move!
Provider Notification: Claims Routing Process Update (Effective February 28, 2024)

2023 Notices

Process for Provider Disputes Regarding Professional Competence or Conduct Revised – Effective November 7, 2023 (posted 10/05/23)
Prior Authorizations – Process Extended to October 8, 2023 – Important Update (posted 9/22/23)
Prior Authorizations – Process Extended to September 22, 2023 – Important Update (posted 9/11/23)
Prior Authorizations – Process Extended to September 8, 2023 – Important Update (posted 9/01/23)
Prior Authorizations – Process Extended to September 1, 2023 – Important Update (posted 8/18/23)
Effective July 1, 2023, Facilities Enrolled in Texas Medicaid Should Submit the Texas Facility Credentialing Application Directly to Verisys (posted 8/15/23)
Prior Authorizations – Process Extended to August 18, 2023 – Important Update (posted 8/04/23)
Prior Authorizations – Process Extended to August 4, 2023 – Important Update (posted 7/31/23)
Prior Authorizations – Important Update (posted 7/7/23)
Prior Authorization Requests: Supporting Clinical Documentation Required for Transplants – Effective May 10, 2023 (posted 4/10/23)
Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers – Ending on May 11, 2023 (posted 3/07/23)

2022 Notices

Marketplace FAQ 2023 (posted 12/27/22)
Community’s Paper Claim Submission PO Box Address Changes Coming in 2023 (posted 10/26/22)
Quality Articles: Teen Nutrition and Annual Physical, Post-Partum Care For High Risk Mothers, Anxiety & Depression Screening, and Teen Vaccinations (posted 7/11/22)
Clinical Laboratory Improvement Amendments (posted 5/9/22)

2021 Notices

House Bill 3459: Prior Authorization Transparency “Gold Carding” (posted 12/10/21).
Prior Authorization Requirements Effective January 1, 2022 (posted 10/1/21)
Texas State of Emergency Declaration (posted 5/21/21)

2020 Notices

2021 Notice to Physicians and Providers on Accepting Applications (posted 12/18/20)
Claims Processing Updates & Reminders (posted 11/4/20)
Medical Review Guidelines Effective 2/1/21 (posted 11/1/20)
Automated Prior Authorization Process (posted 10/5/20)
Claimsxten Update (posted 10/1/20)

Medicare

2024 Notices

Prior Authorization Updates for Marketplace and DSNP (effective January 01, 2025)
Updated Prior Authorization Catalogs for Marketplace and DSNP (effective January 01, 2025)
Skilled Nursing Facility Coinsurance (posted September 3, 2024)
Effective Immediately – Community is Changing Paper Claims Address for All Lines of Business (posted August 27, 2024)
Multi-Factor Authentication implementation in August 2024 (posted August 12, 2024)
Claims Editing Program Notification (Effective on August 1, 2024)
Reminder: LPC and LMFT Providers Must Enroll in Medicare Effective March 1, 2024 (posted April 15, 2024)
Provider Notification: Claims Routing Process Update (posted April 12, 2024)
Community Health Choice is Excited to Announce Our Upcoming Move!
Provider Notification: Claims Routing Process Update (Effective February 28, 2024)

2023 Notices

Prior Authorizations – Process Extended to October 8, 2023 – Important Update (posted 9/22/23)
Prior Authorizations – Process Extended to September 22, 2023 – Important Update (posted 9/11/23)
Prior Authorizations – Process Extended to September 8, 2023 – Important Update (posted 9/01/23)
Prior Authorizations – Process Extended to September 1, 2023 – Important Update (posted 8/18/23)
Effective July 1, 2023, Facilities Enrolled in Texas Medicaid Should Submit the Texas Facility Credentialing Application Directly to Verisys (posted 8/15/23)
Prior Authorizations – Process Extended to August 18, 2023 – Important Update (posted 8/04/23)
Prior Authorizations – Process Extended to August 4, 2023 – Important Update (posted 7/31/23)
Prior Authorizations – Important Update (posted 7/7/23)
Prior Authorization Requests: Supporting Clinical Documentation Required for Transplants – Effective May 10, 2023 (posted 4/10/23)
Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers – Ending on May 11, 2023 (posted 3/07/23)
Update to Community’s Paper Claim Submission PO Box Address Change (posted 1/23/23)

2022 Notices

Community’s Paper Claim Submission PO Box Address Changes Coming in 2023 (posted 10/26/22)
Quality Articles: Teen Nutrition and Annual Physical, Post-Partum Care For High Risk Mothers, Anxiety & Depression Screening, and Teen Vaccinations (posted 7/11/22)
Clinical Laboratory Improvement Amendments (posted 5/9/22)

2021 Notices

Prior Authorization Requirements Effective January 1, 2022 (posted 10/1/21)
Implementation Deadline of Provider Recoupment Policy (posted 8/20/21)

2020 Notices

2021 Notice to Physicians and Providers on Accepting Applications (posted 12/18/20)
Claims Processing Updates & Reminders (posted 11/4/20)
Medical Review Guidelines Effective 2/1/21 (posted 11/1/20)
Automated Prior Authorization Process (posted 10/5/20)
Claimsxten Update (posted 10/1/20)

National Provider Identifier

National Provider Identifier Information

Provider Participation

Become a Community Provider

TX Standard Credentialing App

Forms & Reference Guides

Health Insurance Marketplace

Important phone numbers

Texas STAR/Medicaid

Health Insurance Marketplace

PCP Tool Kit

Alcohol & Substance Abuse Addiction

Bipolar Disorder

Eating Disorders

Major Depression

Provider Notices & Reminders

HHSC Notifications

Health Insurance Marketplace

Membership Rights & Responsibilities

STAR (Medicaid)

CHIP and CHIP P

Health Insurance Marketplace

Why Choose Community?

As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, Community is always working life forward for you and your family.

“Community Health Choice is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.”
– Cecily
Member of Community Health Choice