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) June 2019
Contact Information (PDF) June 2019
Enrollment (PDF) June 2019
Managed Care (PDF) June 2019
System Requirements (PDF) May 2018
Eligibility (PDF) May 2018
Coordination of Benefits (PDF) May 2018
Drug Policy (PDF) June 2019
Home Health Supplies (PDF) June 2019
Vitamins and Minerals (PDF) June 2019
Mosquito Repellent (PDF) June 2019
Drug Utilization Review (PDF) May 2018
Prior Authorization (PDF) May 2018
Pricing and Reimbursement (PDF) May 2018
340B Resources (PDF) Aug. 2019
Payment (PDF) June 2019
Audits (PDF) June 2019
Drug Rebates (PDF) June 2019
Forms (PDF) June 2019

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.