Aug 19, 2025 | Provider Resource
Inpatient high-cost clinician-administered drugs (HCCADs) are drugs or biologics that the Texas Health and Human Services Commission (HHSC) has approved to be “carved out” of the All-Patient Refined Diagnosis Related Group (APR-DRG) and can be billed on an outpatient...
Aug 13, 2025 | Provider Resource
Community First Health Plans would like to remind providers of the THSteps newborn screening requirements and related billing guidance for Medicaid-enrolled infants. Under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), newborn screenings are a...
Aug 7, 2025 | Provider News, Provider Resource
For the latest on claims processing, clinical and updates resources, continuing education, compliance updates, and more, read our Community First 2025 Summer Provider Newsletter, now available on our website. Our Provider Newsletter has curated news specifically for...
Aug 7, 2025 | Medicaid Providers, Provider News, Provider Resource
Influenza is a serious illness that can lead to hospitalization, complications, or even death in young children. Community First Health Plans is seeking your support to ensure that all eligible children aged 6 to 24 months receive two doses of the flu vaccine for...
Jul 18, 2025 | Provider Resource
Due to the severe flooding that impacted communities in the Texas Hill Country on July 4, 2025, the Texas Health and Human Services Commission (HHSC) has issued updated pharmacy benefit guidance. For Members: If you were affected by the flooding, you may now be...
Jul 15, 2025 | Provider News, Provider Resource
HHSC will publish the semi‑annual update to the Texas Medicaid Preferred Drug List (PDL) on July 28, 2025. These changes are based on recommendations from the January 2025 and April 2025 Texas Drug Utilization Review (DUR) Board meetings. The updated PDL and PDL...
