Pharmacy Provider Procedure Manual

The Texas VDP Pharmacy Provider Procedure Manual defines policies and procedures for Medicaid-enrolled pharmacy providers regarding outpatient pharmacy claims, including drug benefit guidance, pharmacy prior authorization, coordination of benefits, and drug pricing and reimbursement.

Chapter Month Revised
Introduction (PDF) May 2018
Contact Information (PDF) May 2018
Enrollment (PDF) May 2018
Managed Care (PDF) May 2018
System Requirements (PDF) May 2018
Eligibility (PDF) May 2018
Coordination of Benefits (PDF) May 2018
Drug Policy (PDF) May 2018
Home Health Supplies (PDF) May 2018
Vitamin and Mineral Products (PDF) May 2018
Drug Utilization Review (PDF) May 2018
Prior Authorization (PDF) May 2018
Pricing and Reimbursement (PDF) May 2018
Health Resources Services Administration (PDF) May 2018
Payment (PDF) May 2018
Audits (PDF) May 2018
Drug Rebates (PDF) May 2018
Resource: Form Directory (PDF) May 2018

Prescribing Providers

Pharmacy Prior Authorization Manual

The Texas Prior Authorization Provider Manual educates Medicaid health care providers about the Texas Prior Authorization program for traditional Medicaid as administered by the Texas Vendor Drug Program.

Texas Medicaid Provider Procedures Manual

The Texas Medicaid Provider Procedures Manual (TMPPM) is a comprehensive guide for Texas Medicaid providers. It contains information about Texas Medicaid benefits, policies, and procedures including medical, dental, and children’s services benefits. Banner messages are used to update the TMPPM.

CSHCN Services Program Provider Manual

The CSHCN Services Program Provider Manual is the prescribing providers’ principal source of information about the CSHCN Services Program. Banner messages are used to update the manual.