Texas Managed Care Organizations (MCOs) must provide Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details about prior authorization. MCO contact information is noted below.
Amerigroup
https://www.availity.com/
Inpatient/outpatient surgeries and other general requests fax: 1-800-964-3627
Behavioral Health fax – inpatient: 1-877-434-7578
Behavioral Health fax – outpatient: 1-866-877-5229
Durable medical equipment (DME) fax: 1-866-249-1271
Therapy (physical, occupational, speech) fax: 1-844-756-4608
Back and spine procedures fax: 1-800-964-3627
Pain management injections fax: 1-866-249-1271
Cardiology, genetic testing, radiation oncology, radiology (high-tech), sleep studies phone: 1-800-714-0040 (AIM Specialty Health) www.aimspecialtyhealth.com/goweb
Home health nursing (other than long-term services and supports) fax: 1-866-249-1271
STAR Kids long-term services and supports (LTSS) fax: 1-844-756-4604
STAR+PLUS long-term services and supports (LTSS)/personal attendant services (PAS) fax numbers by service area:
-Austin: 1-877-744-2334
-El Paso: 1-888-822-5790
-Houston/Beaumont: 1-888-220-6828
-Lubbock: 1-888-822-5761
-San Antonio: 1-877-820-9014
-Tarrant/West RSA : 1-888-562-5160
Nonemergent transportation (other than ambulance) phone: 1-855-295-1636 (Access2Care)
Nonemergent ambulance transportation fax: 1-866-249-1271
Nursing facility fax: 1-844-206-3445
Nursing facility telephone (if urgent): 1-866-696-0710
Pharmacy prior authorization fax:1-800-454-3730
Medical injectable/infusion drugs fax: 1-844-512-8995
Telephone (if urgent): 1-800-454-3730
Medicaid and CHIP Provider Manual: https://providers.amerigroup.
com/ProviderDocuments/TXTX
_CAID_ProviderManual.pdf
Nursing Facility Provider Manual: https://providers.amerigroup.
com/Public%20Documents/
TXTX_NFProviderManual.pdf
STAR Kids Provider Manual: https://providers.amerigroup.
com/ProviderDocuments/TXTX
_CAID_StarKidsProviderManual.pdf
View Prescribers Information for drug authorizations.
Medically necessary LTSS services are authorized within the person-centered care plan by the service coordinator.