The Texas Drug Code Index includes program-specific formularies for Medicaid, the Children’s Health Insurance Program (CHIP), the Children with Special Health Care Needs (CSHCN) Services Program, the Healthy Texas Women (HTW) Program, and Kidney Health Care (KHC) Program. HHSC requires managed care organizations to adhere to the Medicaid and CHIP formularies.
These formularies include:
- Legend drugs
- Over-the-counter drugs
In addition, other products are available as a pharmacy benefit, including:
- COVID-19 vaccines
- COVID-19 test kits
- COVID-19 oral antivirals
- Hepatitis C Treatment Products
- Home health supply products
- Influenza vaccines
- Insulin and insulin syringes
- Long-acting injectables
- Long-acting reversible contraception products
- Mosquito repellents
- Vitamins and minerals
Some drugs are subject to one or both types of prior authorization, clinical and non-preferred.
- All drugs requiring non-preferred prior authorization
- All drugs requiring clinical prior authorization
Some drugs have specific processing requirements: