Clinical Prior Authorization for Calcitonin Gene-Related Peptide Receptor (CGRP) Antagonists in Traditional Medicaid Begins Dec. 30

HHSC will implement the Calcitonin Gene-Related Peptide Receptor (CGRP) antagonists (acute treatment) (PDF) clinical prior authorization for clients in traditional Medicaid on Dec. 30, 2022. CGRP antagonists treat acute migraine headaches.

This clinical prior authorization is optional for managed care organizations (MCOs). The Pharmacy Clinical Prior Authorization Assistance Chart shows each MCO's prior authorization and how those authorizations relate to those used for processing fee-for-service Medicaid claims.  This chart is updated quarterly.  Providers can also refer to the MCO Resources for links to each MCO's list of clinical prior authorizations.