Revised Pharmacy Payer Specification Manual Now Available Separately by Program

VDP revised the current pharmacy payer specification manual to create three separate manuals for the following programs:

• Traditional Medicaid and Healthy Texas Women Program
• Children with Special Health Care Needs Services Program
• Kidney Health Care Program

These manuals include program-specific rules and requirements for claims processing. We recommend you share these manuals with your software and switch vendors to ensure they have the latest version. These and other manuals are available on the VDP Provider Portal.

If you have questions about pharmacy claims processing for the programs above, call the Gainwell Pharmacy and Technical Call Center at 800-435-4165, Monday to Friday, from 7 a.m. to 7 p.m. Central Time.