April 20, 2018

Beginning May 30, Texas HHS will decrease the daily morphine equivalent dose limit for people enrolled in traditional Medicaid. The new limit will be set at 240, and will apply to all opioid prescriptions with exceptions for those people diagnosed with cancer or those receiving palliative or hospice care.  The maximum allowable limit will continue to decrease over time according to the tentative schedule outlined below.

Tentative Date MED Limit
May 2018 240
Sept. 2018 160
Jan. 2019 90

Health plans are not required to follow traditional Medicaid dosage limitations. Prescribing providers should contact the specific health, using the Prescriber Assistance Chart (PDF), for information regarding potential dosage limitations.

More information about these doage limits is available in the Jan. 4, 2018, news article “Morphine Equivalent Dose Limitations for Traditional Medicaid to Decrease”. The Morphine Equivalent Dosing criteria guide (PDF) is available for review. For questions, please email vdp-formulary@hhsc.state.tx.us.