August 8, 2018

Texas HHS will decrease the daily morphine equivalent dose limit for people enrolled in traditional Medicaid on Sept. 24. The new limit will be set at 160, and 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
Sept. 2018 160
Jan. 2019 90

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

Prescribing providers and pharmacy staff should review the morphine equivalent dose criteria guide (PDF) to learn more. Questions may be sent via email to vdp_formulary@hhsc.state.tx.us.