HHSC updated the following three clinical prior authorization criteria guides with the noted changes. These clinical prior authorizations are optional for the MCOs.

Allergen Extracts

• Allergen Extracts criteria guide (PDF)
• Combined the palforzia criteria with the existing allergen extracts criteria
• Added additional ICD-10 codes for peanut allergy (T7801XA, T7801XD, T7801XS) on March 23, 2023

Ileal Bile Acid Transporter (IBAT) Inhibitors

• Ileal Bile Acid Transporter (IBAT) Inhibitors criteria guide (PDF)
• Renamed from Cholestatic Pruritis Agents on March 30, 2023

Monoclonal Antibody Agents

• Monoclonal Antibody Agents criteria guide (PDF)
• Updated references on March 23, 2023