Traditional Medicaid

HHSC requires prior approval with documentation of an appropriate diagnosis. Refer to the Growth Hormone clinical prior authorization criteria document for more information.

CSHCN Services Program

HHSC requires prior authorization for specific diagnoses involving growth hormone deficiency. If an initial or extension request cannot be approved, the request may be sent to program staff for medical review and reconsideration. Prescribing providers complete and submit the Biosynthetic Growth Hormone Products Prior Authorization Request (CSHCN) (HHS Form 1327).

Prescribing providers send the completed form to the CSHCN-enrolled pharmacy, which submits the form. A program-approved provider must complete and sign this form annually, certifying that the client requires these medications.