HHSC provides specific home health supply products as a pharmacy benefit to clients enrolled in Medicaid, CHIP, the CSHCN Services Program, and KHC Program.  The covered products include the following:

  • Aerosol Holding Chamber
  • Diabetic Lancets
  • Diabetic Monitor (talking)
  • Diabetic Test Strips
  • Hypertonic Salines
  • Insulin Needles
  • Insulin Syringes
  • Oral Electrolyte Replacement Fluid
  • Spring Powered Device for Lancet

CMS classifies these products as a Title XIX (Medicaid) home health benefit as either durable medical equipment (DME)  or medical supplies.

Pharmacies are not required to enroll as a Medicaid durable medical equipment (DME) provider to supply these products. Pharmacies already enrolled as Medicaid DME providers can submit claims as either a pharmacy benefit or medical benefit.  Contact the Texas Medicaid and Healthcare Partnership (TMHP) for instructions about submitting medical claims.

A physician must prescribe all DME and home health supplies. Advanced practice registered nurses and physician assistants cannot prescribe these products to clients enrolled in Medicaid or CHIP.

A list of products is available through the Formulary Product search (txvendordrug.com/formulary/formulary-search). You can search by product name, the 11-digit NDC, or select the product from the HCPCS Description dropdown. Additional filters are available to find products payable by each program. Products not included in the search are only available through the Medicaid medical benefit.