Semi-annual Medicaid Preferred Drug List Update Scheduled For Jan. 30, 2025

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Texas Medicaid will publish the semi-annual Medicaid Preferred Drug List (PDL) update on Jan. 30, 2025. We made the PDL changes based on recommendations from the July and Oct. 2024 Texas Drug Utilization Review Board meetings. The July PDL decisions and Oct. PDL recommendations are available. We will publish the new PDL and the PDL Criteria Guide (PDF), which outlines the criteria used to evaluate the non-preferred prior authorization requests, by Jan. 27.

For this update, the "Antidepressants, Other" PDL class will have a new subclass entitled "Post Partum Depression."

As a reminder, drugs with preferred status drugs may include brand name medication, which would not require a PDL prior authorization nor the value of "1" in the "Dispense as Written (DAW) Product Selection code" field (4Ø8-D8). Refer to the Dispense as Written section of the Drug Policy chapter of the Pharmacy Provider Procedure Manual for more information.

HHSC designates drugs on the Texas Medicaid formulary as preferred, non-preferred, or have neither designation. The preferred drug list includes only drugs identified as either preferred or non-preferred:

  • Drugs not on the preferred list, or drugs identified on the list as "preferred", are available to people without prior authorization.
  • Drugs on the list identified as "non-preferred" will require prior authorization.
  • Some preferred and non-preferred drugs may require clinical prior authorization.