December 11, 2018

HHSC will decrease the daily morphine milligram equivalents limit (formerly the morphine equivalent dose), for people enrolled in traditional Medicaid on Jan. 28, 2019. The new maximum allowable limit will be set at 90, and apply to all opioid prescriptions with exceptions for those people diagnosed with cancer or those receiving palliative or hospice care. Additional clinical issue may be considered. This will be the final maximum allowable limit decrease.

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 contact the Texas Prior Authorization Call Center at 1-877-PA-TEXAS (1-877-728-3927) or review the Morphine Milligram Equivalents criteria guide (PDF) to learn more. Questions may be sent via email to vdp-formulary@hhsc.state.tx.us.