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Effective March 1, 2024: Removal of Prior Authorization Requirement for Certain Genetic Procedures
Pneumococcal 20-Valent Conjugate Vaccine Age Range Expansion
Updated January 25,2024 : Texas Medicaid Preferred Drug List Updates
EVV Claims Matching Bypass from January 1 to March 31
EVV Visit Maintenance Processes on Hold for Dates of Service Prior to Go-Live Date with Current EVV
Effective March 1, 2024: Pharmacy and Biopharmacy Policies
Apply Now: Home Health Aide Training Program
Now Available: HHSC Telemedicine and Telehealth Educational Video and Infographics
Test
Test Page January 1, 2024
3 in 30 Assessments for Foster Care Patients
UPDATED: STAR Kids LTSS Billing Matrix
STAR Health Trauma-Informed Care Alternative Payment Model
ACTION REQUIRED: Rate Enhancement
Provider Satisfaction Survey Save the Date
Medicare Member Plan Benefits Resumed for Applicable COVID-19 Testing, Screening, and Treatment Services
Effective August 1, 2023: Pharmacy and Biopharmacy Policies
Medicaid Inpatient Hospital Spell of Illness Policy Extension for COVID-19 Ending
Superior HealthPlan, Pro Football Hall of Famer Darrell Green Help Make First Back-to-School Community Fair & Fest in Kingsville a Success
Upcoming Hepatitis C Educational Webinar for Prescribers
RSV 2022
Upcoming EVV HHAeXchange Webinar
Effective May 1, 2024 Pharmacy and Biopharmacy Policies
Help Protect Your Patients and Your Community Against RSV
Provider Alert: Change Healthcare Cybersecurity Incident and Its Impact to Superior HealthPlan
Effective September 1, 2021: Benefit Changes to Total Disc Arthroplasty for Medicaid and CHIP
Effective July 15, 2021 through December 31, 2021: Temporary Relaxation of Prior Authorization Requirements for DME, Orthotic, and Enteral/Parenteral Nutrition and Medical Supplies
Javelina legend and NFL hall of famer Darrell Green gives back to Kingsville
Barrier Removal Fund (BRF) 2022 Initiative
Provider Notice of Adverse Benefit Determinations
Superior to Override Timely Filing for Claims Impacted by Texas Medicaid Healthcare Partnership’s (TMHP) Eligibility Verification Issues
Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster
Support for Superior Members Affected by Severe Weather, Wildfire, or Other Natural Disaster
Effective January 1, 2024: Retired Medicare Clinical and Clinical Payment Policies
Effective June 1, 2024: New Clinical Payment Policies: Infectious Disease - Lab Screening and Testing
Training Requirement: Model of Care
3 in 30 Assessments for Foster Care Patients
STAR+PLUS: Contract Award Updates
EVV Claims Matching Resumes April 1, 2024; Unmatched EVV Claims will Deny for Payment
REQUIRED: After-Hours, Appointment and Office Site Standards
Availity to Host Live Training Webinars for Providers
IMPORTANT: Updates to HHAeXchange EVV Training Resources
Texas-based Superior HealthPlan Releases Annual Community Investment Report
Effective April 15, 2024: Cranial Molding Orthosis
Secure Portal: Manage Tasks Quickly and Easily
Effective March 25, 2024: Clinical Policies
Effective May 31, 2024: Clinical Policies
2023 – 2024 Respiratory Syncytial Virus (RSV) Season Changes
Effective June 1, 2024: Pharmacy and Biopharmacy Policies
Effective April 1, 2024: Pharmacy and Biopharmacy Policies
EVV Visit Transaction Rejection Codes to Begin April 1, 2024
members-rate-their-provider-experience-03262024
REQUIRED: Prior Authorization for Nursing Facility Add-On Therapy
NOW AVAILABLE: HHS Briefing on Change Healthcare
Drug Take Back April 2024
Health Passport Requirements for Behavioral Health Providers Serving STAR Health Members
April 27: Drug Take Back Day
Resolving Payment Discrepancies on Claims
Effective 04/22/24: Durable Medical Equipment, Prosthetics, Orthotics, and Medical Supplies Online Platform
NEW: Partnership and Appointment Platform with Grow Therapy
Access Behavioral Health Tools and Resources
Billing EVV Services as Secondary Insurance Claims
NEW: Change Healthcare Availity and Zelis Processes
Updated EVV Home Health Care Services Bill Codes Table
UPDATED: Timeframe for Clinical Information for Acute Inpatient Facility Providers
ACTION REQUIRED: CMS Annual Drug Utilization Review Survey for FFY 2023
PROHIBITED: Balance Billing
Register for Upcoming LTSS Recruitment and Retention Webinar
Effective August 1, 2024: Prior Authorization for Certain Genetic Procedure Codes
Effective May 1, 2024: Pharmacy and Biopharmacy Policies
ACTION REQUIRED: Confirm Your Provider Information is Accurate
Attention: Providers in the Travis Service Delivery Area
Now Available: Trainings for Hospital Providers
EVV Alternative Device Phase-Out Schedule for Public Comment – Due by May 15
Effective May 1, 2024: Removal of Prior Authorization Requirement for Certain Medical Eye Procedures
Updates to the EVV Visit Maintenance Processes Hold for Dates of Service Prior to Go-Live Date
AcariaHealth Remains In-Network and a Preferred Specialty Pharmacy
Effective July 1, 2024: Pharmacy and Biopharmacy Policies
Effective August 1, 2024: Clinical Policies
Do Your Patients Understand Their Rights and Responsibilities?
Superior HealthPlan Employees Show Support for March of Dimes in Austin
Asthma Awareness Month: Inclusion of National Guidelines into Clinical Practice
Secure Portal: Manage Tasks Quickly and Easily
ATTENTION LTSS PROVIDERS: 2023 Cost Report Due to HHSC by 5/15
Provider Credentialing Information and Rights
EVV Compliance Grace Period Extended
Effective August 1, 2024: Pharmacy and Biopharmacy Policies
Effective June 1, 2024: Pharmacy and Biopharmacy Policies
Effective May 22, 2024: Clinical Policies
Effective May 27, 2024: Clinical Policies
Effective June 28, 2024: Clinical Policies
Effective July 31, 2024: Clinical Policies
Effective June 1, 2024: Revised Payment Policy: Code Editing Overview
Ascension Cybersecurity Incident Provider Accommodations
Provider Training Opportunities and Special Events
EVV PSO 2024 Onboarding Schedule and Enrollment Information
IMPORTANT: Updates to the Provider Statement of Need Form
3 in 30 Assessments for Foster Care Patients
HHSC STAR+PLUS Upcoming Webinars
June 13: Hepatitis C Webinar for Prescribers
Care Management: Helping Providers Assist Superior Members
Effective 9/1: STAR+PLUS Contract Changes
2024 EVV Proprietary System Request Form Submission Deadline July 15, 2024
Adding Behavioral Health Providers to Maternal Mental Health Treatment Network
Training Requirement: Model of Care
Effective July 1, 2024: Pharmacy and Biopharmacy Policies
Effective September 1, 2024: Pharmacy and Biopharmacy Policies
IMPORTANT: Billing Notice to Behavioral Health Providers
2023 Cost Report Training Information for LTSS Providers
Effective October 1, 2024: Prior Authorization Update for New CPT Codes
Reminder: EVV Home Phone Landline Requirements
Effective June 1, 2024: Elimination of Certain Laboratory Services Payment Policies
Effective 10/1/24: Co-pays will Resume for CHIP COVID-19 Services
IMPORTANT: Medical Records Retrieval Project
Home Telemonitoring Services Adding Federally Qualified Health Centers and Rural Health Clinics
Important Cultural Competency, Health Equity and NMDOH Resources
REQUIRED: After-Hours, Appointment and Office Site Standards
Effective October 31, 2024: Clinical Policies
Effective September 30, 2024: Clinical Policies
Effective July 22, 2024: Clinical Policies
Effective October 1, 2024: Pharmacy and Biopharmacy Policies
Upcoming LTSS Recruitment and Retention Webinar
Provider Satisfaction Survey
Upcoming Provider Satisfaction Survey
EVV Policy Reminder for Severe Weather
Effective 9/1/24: Procedure Code Update for Dental Anesthesia Prior Authorization Requests
Additional 2023 CPC Cost Report Training Information for LTSS Providers
Effective 10/31/24: Behavioral Health – Substance Use Disorder Treatment Criteria
Effective 7/25/24: Texas Medicaid Preferred Drug List Updates
Effective November 11, 2024: Clinical Policies
New and Revised Clinical Payment Policies and Code Editing Payment Policy Reminder for Marketplace
Requirements for Claim Submissions
NEW: Provider Tool for Enhancing Care for those with IDD and Communication Barriers
Effective 9/1/24: Genetic Services Biomarker Testing
Tips for your Practice: Chlamydia Screening Recommendations
Healthcare Resources and Alternatives to Use in Your Practice
Effective September 1, 2024: Pharmacy and Biopharmacy Policies
Effective November 1, 2024: Pharmacy and Biopharmacy Policies
ACTION REQUIRED: Rate Enhancement Affidavit
IMPORTANT INFORMATION: For Providers in the Bexar SDA
Effective 9/1/24: Influenza Vaccine Procedure Code Becomes a Benefit of Texas Medicaid
Improving Health through Quality Improvement
Clarification: Lumbar Sacral Orthotics Criteria
Effective 10/1/24: COVID-19 Vaccine Administration Updates for Medicaid and CHIP
IMPORTANT: STAR+PLUS Authorization for Services that Require the Use of EVV
IMPORTANT: CDI Upcoming Webinars
Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster
REMINDER: Updated TAC References in CDS Forms
HHSC REMINDER: Postpartum Medicaid and CHIP Coverage Extension
Effective December 1, 2024: Pharmacy and Biopharmacy Policies
Effective December 1, 2024: Pharmacy and Biopharmacy Policies
Resource for Members: Pyx Health
REGISTER NOW: In-Person Trauma-Focused Cognitive Behavioral Therapy Training
Effective 9/1: STAR+PLUS MCO-to-MCO Transfer of Authorizations
Effective September 23, 2024: Clinical Policies
Effective 10/01/24: RSV Vaccine Procedure Code 90683 Becomes a Benefit of Texas Medicaid
EVV Compliance Grace Period Ends December 31
NEW: HHSC EVV Policy Handbook Revisions
2024-2025 RSV and Synagis® Season Prior Authorization
Effective November 1, 2024: Pharmacy and Biopharmacy Policies
Effective January 1, 2025: Pharmacy and Biopharmacy Policies
Update to Unit Limitations for Certain Medical Supplies
Effective February 1, 2025: Clinical Policies
EVV Alternative Device Reduction Schedule
COPD Awareness Month: Tips, Tools, and Resources
Reminder: Medicaid Third Party Liability Provider Requirements
REQUIRED: Adult Foster Care Residential Agreement Checklist
Effective 12/27/24: OnTrak Partnership Ends
Effective December 1, 2024: Pharmacy and Biopharmacy Policies
Effective November 25, 2024: Clinical Policies
Effective January 31, 2025: Clinical Policies
Effective 12/1/24: Certain Non-Surgical Services Procedure Codes Updates
Training Requirement: Model of Care
REMINDER: EVV Compliance Grace Period Ends December 31
EVV PSO ORR Sessions Updates
Effective September 1, 2024: Pharmacy and Biopharmacy Policies
Effective October 1, 2024: Pharmacy and Biopharmacy Policies
IMPORTANT: HHSC Medicaid Provider Enrollment Revalidation Flexibilities
Effective January 1, 2025: Pharmacy and Biopharmacy Policies
Effective March 1, 2025: Pharmacy and Biopharmacy Policies
Payment Policy Posting and Updates
Effective April 1, 2025: Sleep Studies Clinical Policies
Effective March 31, 2025: New and Revised Clinical Payment Policies
Notice to Physicians and Providers
Effective 1/30/2025: Texas Medicaid Preferred Drug List Updates
2024 Cost Report Training Information for LTSS Providers
Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster
IMPORTANT: Post-Service Medical Necessity Appeal Submissions
2025 Medicare and MMP Formulary Changes
Same-Day Texas CANS 3.0 Assessments and Psychological and Neuropsychological Testing for STAR Health
Medicare Prescription Payment Program
Effective April 30, 2025: Clinical Policies
Effective January 27, 2025: Clinical Policies
Effective March 31, 2025: Clinical Policies
Effective April 20, 2025: Clinical Policies
Effective April 20, 2025: Concert Genetic Testing Policies
Superior HealthPlan Recognized as a Best Place for Working Parents® in Texas
Effective 4/1/25: HHSC Revisions to the Uniform Opioid Policy
Effective May 1, 2025: Pharmacy and Biopharmacy Policies
Effective March 1, 2025: Pharmacy and Biopharmacy Policies
Effective May 1, 2025: Pharmacy and Biopharmacy Policies
Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster
Effective March 1, 2025: New Medicaid Benefit - Certified Family Partner Services
Important Resource for Hospital Providers
Effective April 7, 2025: Pharmacy Coverage Updates for COVID-19 Test Kits and Vaccines
3/12/25 UPDATE: HHSC EVV Policy Handbook Revisions
Important Resources for Providers
Effective June 1, 2025: Pharmacy and Biopharmacy Policies
Effective April 1, 2025: Pharmacy and Biopharmacy Policies
Effective April 1, 2025: Removal of Prior Authorization Requirement for Certain Sleep Studies
Members Rate Their Provider Experience
Effective March 31, 2025: Clinical Policies
Effective May 30, 2025: Clinical Policies
Tango-WellSky Partnership with Centene to Support Medicare Members
Effective July 1, 2025: Changes to Prior Authorization Requirements for Cardiology Services and Procedures
Cardiology Procedures: Transition of Utilization Review from TurningPoint to Evolent Effective for Service Dates beginning July 1, 2025
Important Notice: Enforcement of Claim Filing Guidelines
Effective July 1, 2025: New Payment Policy: Inpatient Claim Billing/Coding Reviews
Upcoming Provider Satisfaction Survey
Coming Soon: PEMS Update to Allow Provider Credentialing
Effective July 1, 2025: Revised Payment Policy: Genetic and Molecular Testing Services
Effective May 1, 2025: Pharmacy and Biopharmacy Policies
Effective July 1, 2025: Pharmacy and Biopharmacy Policies
REQUIRED: 2024 Cost Reports for LTSS Providers
Effective August 1, 2025: New Prior Authorization Requirement for Certain Neurostimulators
Effective August 1, 2025: Clinical Policies
Effective August 1, 2025: Genetic Testing PLA Expansion
LTCOP Transitioning from RUG to PDPM LTC for Nursing Facilities
Effective July 15, 2025: Pharmacy and Biopharmacy Policies
Effective July 31, 2025: Clinical Policies
POSTPONED: Update to Allow Submission of Provider Credentialing Applications through HHSC’s PEMS for Medicaid and CHIP
Reminder: Tango-WellSky Partnership with Centene to Support Medicare Members
Change in Preferred Drug List Status for Glucocorticoids - Inhaled Drug Class Began on May 6, 2025
Effective May 20, 2025: Clinical Policies
Now Available: HHAeXchange EVV System Survey
Separate Reimbursement of Certain Inpatient High-Cost Drug and Biologics
IMPORTANT NOTICE: Rider 32 Implementation Information
Effective June 1, 2025: Pharmacy and Biopharmacy Policies
Effective August 1, 2025: Pharmacy and Biopharmacy Policies
Superior HealthPlan Awards $200,000 in Grants to 20 Community-Based Organizations and Providers
Effective June 30, 2025: Superior HealthPlan to Discontinue Tomorrow Health DME-POS Pilot Program for Members in Bexar Service Delivery Area
ATTENTION SUPERIOR HEALTHPLAN PROVIDERS:
REMINDER: Ambetter Health Solutions Now Available
NEW RESOURCE: Quality Rating System (QRS) Behavioral Health Measure Toolkit
IMPORTANT: MHTCM and MHR Services Provider Attestation Requirements for State Fiscal Year 2026
Apply Now: Home Health Aide Training Program for STAR+PLUS Providers
IMPORTANT: Update on ELEVIDYS for Non-Ambulatory Clients
Effective July 1, 2025: Pharmacy and Biopharmacy Policies
Effective September 1, 2025: Pharmacy and Biopharmacy Policies
Events
(Webinar) Hospitals Provider Training
(Webinar) Hospitals Flash Trainings-Medical Necessity Appeals
(Webinar) Travis: Provider Advisory Group
Central: Provider Advisory Group
(Webinar) Electronic Visit Verification (EVV)
(Webinar) Superior Nursing Facility Training
(Webinar) Long-Term Service and Supports (LTSS) Billing Clinic
(Webinar) STAR Health
(Webinar) Comprehensive Billing Clinic
(Webinar) Wellcare By Allwell (Medicare Advantage)
(Webinar) STAR Kids
(Webinar) Ambetter from Superior HealthPlan
(Webinar) STAR/CHIP/STAR+PLUS
(Webinar) Superior Medicare-Medicaid Plan (MMP)
(Webinar) STAR Kids Long-Term Service and Supports (LTSS) Billing Clinic
(Webinar) Behavioral Health Billing Clinic
(Webinar) Cultural Competency and Disability Sensitivity Training
Lower West: Provider Advisory Group
Bexar: Provider Advisory Group
Hidalgo: Provider Advisory Group
Nueces: Provider Advisory Group
(Webinar) Evolent Introductory Session
(Webinar) Evolent Interventional Cardiology Provider Training
(Webinar) Evolent Introductory Session
(Webinar) Evolent Interventional Cardiology Provider Training
(Webinar) Evolent Introductory Session
(Webinar) Evolent Interventional Cardiology Provider Training
(Webinar) Evolent Interventional Cardiology Provider Training
(Webinar) Evolent Interventional Cardiology Provider Training
(Webinar) Evolent Interventional Cardiology Provider Training
(Webinar) FQHC Training
(Webinar) Dallas: Provider Advisory Group
Lubbock: Provider Advisory Group
(Webinar) Northeast: Provider Advisory Group
Harris/Jefferson: Provider Advisory Group
(In Person) Dallas: Behavioral Health Town Hall
(Webinar) Electronic Visit Verification (EVV)
(Webinar) STAR Kids
(Webinar) Comprehensive Billing Clinic
(Webinar) STAR Health
(Webinar) Ambetter from Superior HealthPlan
(Webinar) Superior Medicare-Medicaid Plan (MMP)
(Webinar) STAR Kids Long-Term Service and Supports (LTSS) Billing Clinic
(Webinar) Wellcare By Allwell (Medicare Advantage)
(Webinar) Cultural Competency and Disability Sensitivity Training
(Webinar) Superior Nursing Facility Training
(Webinar) STAR/CHIP/STAR+PLUS
(Webinar) Behavioral Health Billing Clinic
(Webinar) Hospital Flash Trainings - Prior Authorization Submissions
(Webinar) Hospitals Flash Trainings-Superior's Secure Portal-Locating an EOP
(Webinar) Hospital Flash Trainings-Prior Authorization Submissions
(Webinar) Hospital Provider Training
(Webinar) Hospital Flash Trainings - Prior Authorization Submissions
(Webinar) Hospitals Flash Trainings - Medical Necessity Appeals
(Webinar) Hospital Flash Trainings - Superior's Secure Portal- Locating an EOP
(Webinar) Hospital Provider Training
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